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The Comprehensive Guide To Birth Control and Fertility

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Does birth control make you gain weight? Cause infertility? Help with acne? Issues of birth control, pregnancy, and fertility are critically important to many adults but there are many rumors and rumors and misinformation to contend with. 

To help separate fact from fiction, we are taking a look at the myths surrounding birth control and its effect on fertility and other issues. Read on for a comprehensive look at types of birth control, their effects, and their rates of effectiveness.  

Effectiveness of Birth Control Types

Currently, there are more than a dozen recognized forms of birth control with effectiveness rates ranging from 71% effective to 99% effective.  Here we will take a brief look at each. 

99% Effective Birth Control Methods

Arm Implant: An arm implant is among the most effective and longest lasting birth control methods. This hormone-based implant is inserted into your arm by your doctor and will continue to release pregnancy-preventing progestin for up to 5 years or until your doctor removes it. 

Pros: Arm implants are highly effective, long-lasting, low maintenance and can decrease cramps associated with menstruation. Also, unlike oral contraceptives, you do not risk forgetting to take your birth control. 

Cons: Serious complications from implants are rare but some patients may experience infections at the site of insertion, headaches, and bleeding. You should also be aware that there is a chance that the implant may move. If you no longer can feel your implant in your arm, contact your doctor immediately to determine if the implant has moved and needs to be extracted. 

Hormonal IUD: A hormonal IUD is a small, plastic T-shaped device that is inserted into the uterus by your doctor. This, like the arm implant, also releases the hormone progestin. Progestin prevents eggs from being released from the ovaries. Therefore, they cannot be fertilized. 

Pros: Unlike the arm implant, you will not feel the hormonal IUD once it is in place. Though there are small strings that protrude slightly from the cervix, neither you nor your partner will feel these. This style of IUD can last up to 7 years.  

Cons: The most common side effects of a hormonal IUD are cramps and backache for the first few days after the device is inserted. You may also notice light vaginal spotting between periods for the first several months after insertion. Rarely, complications may arise from an infection or if the IUD pokes through the uterine wall. 

Copper IUD: The copper IUD is very similar to the hormonal IUD in that it is inserted in the same way and has the same risks and benefits. However, it has the advantage over a hormonal IUD in two ways:

  • Longest lasting birth control with up to 12 years of protection. 
  • It is the only 99% effective birth control that does not contain hormones. 

Birth Control Shot: The birth control shot contains the hormone progestin and is administered by your healthcare provider every three months. 

Pros: Unlike IUDs that are inserted, there is no risk of a device moving and causing problems. Instead, the shot is quickly administered every three months for 99% effective birth control with minimal side effects.

Cons: With a shot, you may notice increased mood swings, weight gain, acne, and soreness in your breasts. However, one of the biggest risks associated with the shot is that patients often fail to get their dosage on time. When you delay getting your dosage, the effectiveness of the shot drops to 94%. 

Vasectomy/Tubal Ligation: Vasectomy (for men) and Tubal Ligation (for women)  are surgical, permanent birth control forms. Each is considered 99% effective. Complications and risks are rare with both procedures but Tubal Ligation is more invasive. Technically, both procedures can be reversed but it can be a complicated procedure that is not guaranteed to restore fertility. 

91% Effective Birth Control Methods 

Birth Control Pill: Birth control pills cover a wide range of brands and varieties of oral contraceptives but all work similarly. With this method, you take a pill each day which releases estrogen and progestin. Since there are multiple types and brands, side effects can vary. Users commonly report headaches, mood swings, decreased sex drive, and spotting between periods. In some cases, blood clots can form but this is rare.

Pros: A pill does not require you to visit your doctor every three months the way the shot does. If you have acne, the pill can help to reduce this along with pain during menstruation.  You can also attempt to get pregnant as soon as you stop taking the pill.

Cons: The pill can affect your mood, decrease sexual interest, cause headaches and bloating. Forgetting to take your pill daily will increase the likelihood of you getting pregnant. 

Note: There is also a “minipill” which contains a lower dose of hormones. Your doctor will be able to tell you if this option is right for you. 

Vaginal Ring: The vaginal ring is a soft, flexible ring that is inserted into the vagina for three weeks out of the month. It also uses hormones to prevent pregnancy. On the fourth week of the month, you remove the ring to have your period naturally.  

Pros: Like the pill, the ring will help to reduce acne and body hair. It is also comfortable for most patients and your partner will not be able to feel it during intercourse. 

Cons: Blood clots may occur though this is rare. Those who smoke and/or who have high blood pressure will increase their risk of this complication. The ring’s effectiveness is also reduced when not used properly, i.e. not removed or replaced when required. 

71% to 88% Effective Methods

 

  • 88% Effective Diaphragm: A diaphragm is a small silicone cup that fits over the cervix. It is placed just before sex and prevents sperm from entering. The diaphragm is beneficial in that it does not contain hormones or side effects. However, fitting the device correctly can be difficult which reduces its rate of effectiveness. 

 

  • 71% Effective Spermicide: Spermicide is a cream that kills sperm. To optimize the effectiveness of this cream, it should be combined with condoms and/or a diaphragm. When used on its own, it can be difficult to get adequate protection. 
  • 85% Effective Condoms: perhaps the most common form of birth control, condoms are a thin sheath of latex placed over the penis before sex. While they are the only birth control that is effective in preventing STDs, they are not the most effective at preventing pregnancy. Optimally, combine condoms with another form of birth control to get the best protection from both STDs and pregnancy.
  • Natural Methods: Natural methods of birth control involve tracking fertility days. While this can be up to 88% effective when done perfectly, it is not a perfect system. Those with irregular menstruation cycles should not use this as their only form of birth control. 

 

 

Quick Facts About Birth Control

  • Condoms are the only birth control that reduces the chances of contracting a sexually transmitted disease.
  • A copper IUD is the only 99% effective form of birth control that does not contain hormones.
  • The only permanent form of birth control is tubal ligation and vasectomy. 
  • Some forms of birth control, such as the vaginal ring, can increase the risk of blood clots. This is especially dangerous for those with unmanaged blood pressure and for those who smoke. 
  • Using other forms of birth control such as the pill or vaginal ring along with condoms can provide better protection from both pregnancy and STDs. 
  • The pill and the vaginal ring can both reduce acne and body hair. 

Does Birth Control Cause Infertility?

It is a common myth that the birth control pill will cause infertility. However, there is no truth to this. As with all of the previously mentioned birth control methods (with the exception of tubal ligation and vasectomy), you can cease use and begin trying to get pregnant immediately.

How Long Should it Take to Get Pregnant?

It is a common trope in pop culture that women will get pregnant almost immediately. Because of this, many women attempting to get pregnant feel there is something wrong if they do not conceive within a month or two.  However, while pregnancy can happen this quickly, it is just as common for it to take several months or even a year of regular attempts. 

As a general rule,  women under the age of 35 should not be concerned about infertility until they have attempted to get pregnant for a year or more. Women 35 to 40 can continue to attempt getting pregnant for up to 6 months before seeing a doctor about fertility issues. However, those who are over 40 should seek medical guidance from the start. Tests can show your likelihood of conceiving naturally and fertility treatments can be administered as needed. 

Final Thoughts on Birth Control and Fertility 

Infertility is a common issue and there are many reasons for it. However, birth control is not one of them. If you are concerned about your ability to get pregnant, speak with your doctor. There are several modern treatments and solutions to help increase the probability of conceiving.

At BCML, our caring medical professionals are here to guide you through all your health concerns including birth control and fertility. To schedule a consultation, contact us at 416-921-2121 & 1-800-667-0923 (toll free #). 

The Dangers of Vaping for Your Health

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Are you vaping instead of smoking because you think it’s healthier? If so, you are not alone. For years, vaping has gained popularity largely due to the assumption that it is safer than smoking. 

However, some studies indicate it can affect your health in many of the same ways as smoking.  It can be particularly dangerous for teens and young adults whose brains may be affected more readily since they are still developing. 

Here we will look at the dangers of vaping for your health and what you can do to seek help for vaping cessation. 

Effects on the Lungs and the EVALI Disease 

Many believe that vaping is safer than smoking because there is no smoke to inhale. However, a vaping device creates an aerosolized spray that you also take into your lungs. With vaping liquid containing nicotine along with a multitude of other chemicals, it is easy to see why this can be problematic for your lungs.  

Since vaping is still a relatively new practice, it has only been within the past few years that medical experts have identified E-cigarette or Vaping Product Use-associated Lung Injury (EVALI). With EVALI you can experience a range of symptoms that mimic other illnesses like pneumonia which can make it difficult to diagnose. This can include coughing up blood, abdominal pain, dry cough, vomiting, chest pain, shortness of breath, and more. 

While steroid treatments are effective and most patients make a full recovery, some patients will need oxygen to supplement their laboured breathing. Moreover, those who continue to vape are more likely to relapse. 

Could Vaping Make it Hard to Focus? 

Nicotine in vaping liquid may have long-term or even permanent effects on the brain including issues with focusing, depression, mood disorders, and more. Teens and young adults are particularly vulnerable to these side effects as their brains are still developing. 

These issues are largely due to the addiction that nicotine creates in the brain. When your brain is addicted to a substance, it will affect receptors in your brain responsible for producing dopamine, a chemical that is associated with making you feel good. You can also get this from things like eating foods you enjoy, being around someone you are attracted to, or when you accomplish something like getting a good score on a test. 

The issue with getting dopamine from a drug like nicotine is that a user will suffer from withdrawal when that substance is taken away. This can cause feelings of sadness, inability to concentrate, headaches, and much more. 

More importantly, the more you use, the more you will need to achieve the same effects. Eventually, you will no longer achieve the same effects but still crave the substance while also experiencing the physical harm associated with inhaling vape fume. 

Why is Vaping Particularly Bad for Teens and Young Adults? 

If you are under 25, your brain is still growing and developing. This is what makes it possible to learn and retain new skills much more easily at this age versus later in life. Unfortunately, that same quality will make you more prone to retaining addiction. 

Your brain learns to associate vaping and nicotine with feeling good early on and it will have a difficult time forgetting that. This is why you may be able to logically tell yourself that you do not need to vape when you try to quit, but your brain will not stop demanding what it is craving. It may then struggle to produce dopamine, producing the feeling that you need to smoke in order to feel good.  

Vaping when you are young not only makes it more difficult to quit, it also means you have that many more years to develop other potential problems if you continue. The good news is that the sooner you stop, the more you can reduce your risks now and in the long-term. 

What if I Only Smoke Occasionally? 

Vaping in any capacity can cause addiction to nicotine. Addiction to nicotine is an extremely common issue that can happen to anyone. Often, users who claim to vape casually or infrequently will eventually become regular users. Each individual is different and you may take more or less time to become addicted based on how often you use. While you may evade addiction for a time, the longer you continue, the greater your chances of developing a dependence or other issues. 

Can I Use Vaping to Quit Smoking? 

Vaping to stop smoking is not ideal but, yes, this is what vaping was originally intended for. While there are other methods of smoking cessation that may be healthier, vaping can reduce withdrawal symptoms and make it easier to abstain. However, you should not continue vaping indefinitely. Ideally, you will slowly reduce the amount of nicotine you vape with until you can eliminate it entirely. 

Cost of Vaping 

Along with potentially harmful side effects, vaping can also be expensive. While your total cost will depend on several factors including how much and how often you vape, average users can expect to spend over $800 annually. If you vape more often and use more expensive vape juice, this cost can increase exponentially. 

How Much Could you Save if You Quit Vaping? Assuming you are a moderate user who spends around $15/week on vaping, which is the equivalent of replacing one pack of cigarettes per day with vaping, you will spend $780 annually. A heavy user can easily double this amount. 

An average user who smokes throughout four years at university would spend over $3,000 on vaping while earning their degree. That same $3,000 could be used as a down payment on a car, for several months’ rent, or to pay off any schooling costs. If you have student loans or credit cards with an outstanding balance, that $3,000 becomes even more significant when you consider the interest that you are paying. 

The Greatest Dangers May Still be Unknown

Perhaps the most concerning factor in understanding the dangers of vaping is that the practice has not been around long enough to understand the full effects. While smoking nicotine has been a practice for hundreds of years, vaping has been around for less than 20. 

With smokers, the medical community now knows that some issues may not develop until many decades later. Even a person who quits smoking will still have an elevated risk of certain cancers later in life. This could also prove true for vaping. However, it is important to note that smokers do reduce their risks when they quit. Therefore, quitting is a worthy goal to pursue. 

Seeking Help for Vaping Cessation

While the effects of vaping are concerning, you may be able to reduce or even reverse the damage by quitting. To create an effective plan for quitting, talk to a doctor about what is best for you. 

At BCML, we help our patients manage their total health including vaping and smoking cessation. Our caring and knowledgeable physicians can help you find healthy ways to quit. To schedule a consultation, call BCML at 416-929-1900.

Meditation, Mindfulness and Mental Health

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According to a 2020 Nanos Survey, twice as many Canadians report experiencing constant stress since the rise of the pandemic compared to before. Stress, anxiety, and depression are extremely common conditions that can affect anyone at any time. Now, with these issues increasing daily across the country, mindfulness for mental health has become an important topic. 

Can meditation help you feel better? Here we will look at the connection between mindfulness and mental health and how you can begin experiencing the potential benefits of meditation practices. 

Is Meditation Good for Your Mental Health?

A  2012 review of anxiety studies showed that meditation may have a positive effect on acute anxiety. Similar studies have also suggested that common issues like high blood pressure, depression, and chronic pain can also be aided by meditative practices.

Why is this so important? While meditation is not a cure or guaranteed treatment for mental health concerns, it can be a healthy, supportive coping tool to help manage symptoms. Additionally, meditation is free, does not involve medications and anyone of any physical ability can practice it.

However, it is important to note that chronic mental health conditions may not respond to meditation. Additionally, about one in twelve people may experience a worsening of certain symptoms. This is thought to be due to the mind fighting against the attempts at calm and/or may be a sign you should try another form of meditation. 

So, is meditation good for your mental health? The ultimate answer is that it will likely have a positive effect but does not work the same for everyone. If you are new to finding the connection between mindfulness and mental health, it is best to start slowly and manage your expectations. We will look at ways to start mindfulness slowly later in this post. 

What are Meditation and Mindfulness?

Meditation: includes various exercises to clear one’s mind and achieve physical relaxation. However, this does not mean your goal should be perpetual calm or an absence of thought. Meditation is, instead, often used as a way to allow yourself to think freely without judgment of your own thoughts.

There are many ways to practice meditation to achieve different effects. For most people new to meditation, this will include some form of controlled breathing exercise, sitting quietly to clear your mind, or taking a walk where you learn to focus on the feel of each step instead of your inner thoughts.

Mindfulness: and meditation are opposites of each other but can be practiced together. It can be somewhat more difficult to define mindfulness as you can choose to be mindful of many things. For example, a common mindfulness goal is achieving a compassionate, judgment-free state of mind. It can also simply be to be aware of and live in the moment where you are not allowing the past or future to intrude on your present thinking. While meditation is typically performed in a quiet space, mindfulness can be practiced anywhere even when there are other noises or people. 

Mindfulness Meditation: is designed to clear one’s mind. Breathing exercises or focused walking could fall into this category. Instead of being mindful of more complex things like emotions or concentrating on the present, you focus on your physical movements or breathing. 

What to Expect When you Begin Meditation

One of the ways to increase your success with mindfulness and meditation is to manage your expectations. The first time or even the first several times you sit down to meditate you may find that you cannot focus on just your breathing or any one thing. This is very common and normal. Meditation, like all things, takes practice.  

Gradually, over the course of weeks or months, you may find that you can achieve a calm, meditative state much more easily. Ideally, this calm will remain with you even when you are not actively meditating. As you continue, you may find your thoughts are clearer and you can focus more readily.

Simple Ways to Begin Meditation and Mindfulness Practices 

Starting new habits can be daunting. Our personal psychology often seems stacked against us when we attempt new behaviours. 

However, mindfulness and meditation can be practiced on all levels and started with only a few minutes a day in some cases. Here are some top ways you can easily begin good meditation and mindfulness for mental health practices:

  • Set Aside Time to Practice: The simplest way to get started with meditation is to set aside time each day to sit quietly without distractions. When possible, use the same spot and time of day consistently. This will help you get into regular practice.
  • Follow a Guided Meditation: A wealth of guided meditation videos or audio recordings can be found easily online. Some will have specific goals like helping you to concentrate while others will help you focus your breathing. These can be especially helpful if you find that you cannot stop intrusive thoughts. The recording itself will give you something to focus on. 
  • Practice Being in the Moment: If you find that you are struggling to enjoy simple experiences like a nice meal or a conversation, try to be mindful of your current activity. One way to do this is to allow yourself a set time for a certain activity and commit to focusing on that one thing for that duration. For some, allowing a specific time for a meal without other distractions can help you enjoy your food more and control your portions. 
  • Take a Break from Your Phone: Our phones and computers are great tools for many things (like guided meditations for example) but they are also major distractions. If you feel that you are stressed because you are constantly scrolling through social media, reading news updates, answering texts, etc. then consider a timeout from your electronic devices. 

During that time, consider reading a book, writing in a journal, or even doing a jigsaw puzzle. If possible, have an in-person conversation with a friend or loved one where you do not stop to check your phone during that time. 

This particular option may prove difficult for many as addiction-like reliance on our phones and the internet is a very real concern. However, if you can stick with this, you will find that it gets easier to stop constantly looking at your phone. 

When to Seek Help for Mental Health Concerns

While there can be benefits of meditation for most people, it is not intended to be a cure or proven treatment for mental health conditions. Anxiety, depression, and other mental health concerns are extremely common and can affect anyone. If you find that your mental health is affecting your ability to function or you experience chronic or severe symptoms, it is time to seek professional help. 

Both medications and professionally guided therapies can help to reduce or control symptoms of mental health conditions. Underlying physical issues may also be contributing to your stress, anxiety, or depression. A medical evaluation will help identify the causes and ensure you are getting proper support and treatment. 

Final Thoughts on Meditation, Mindfulness and Mental Health 

Like with most habits, beginning a meditation routine is something you should give time to before expecting results. Treat yourself with compassion and understand that missing a day or two in your routine is not a failure. 

It is an opportunity to regroup and try again or to focus on a different method of meditation. In short, finding balance in mindfulness and mental health is intended to be a marathon, not a sprint.  Most importantly, if you find that your symptoms are not manageable, seek professional evaluation and care. 

At BCML, we are here to support you in all your physical and mental health needs. To schedule an appointment with our caring and knowledgeable physicians, please call 416-929-1900 . 

Vaping vs Smoking: The Dangers of Both

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Vaping vs smoking: Is vaping really safer? In recent years vaping has quickly become a popular alternative to smoking, especially among college students. Often described as being safe or safer compared to smoking, many believe or assume there are fewer harmful additives compared to cigarettes. While there may be some truth to this, less risk is not the same as no risk. For example, some e-cigarettes may be easier on your lungs, but continue to pose a risk to your brain. 

Here we will look at the differences between vaping vs smoking, the long term effects of vaping and smoking and which may be less harmful. 

Differences Between Vaping and Smoking 

Method: The most obvious difference with vaping vs smoking is how a user takes in the product. With traditional cigarettes, tobacco is burned and inhaled into the lungs. Comparatively, vaping involves heating a liquid that typically includes nicotine. This heat creates an aerosol spray which a user inhales.

Effect on Lungs: While these methods are different, nicotine and other chemicals are still taken into the lungs with both. An aerosol spray is less harmful, but the nicotine is also still addictive and there is a risk of a serious lung injury known as EVALI which we will discuss further. 

Contents: Traditional cigarettes contain over 7,000 chemicals, many of which are known to cause harm to the lungs, heart and other organs. Vaping liquid typically contains water, propylene glycol, nicotine and flavorings. While vaping liquid’s known ingredient list is shorter, the contents are not well regulated. Moreover, while propylene glycol is generally considered safe for human consumption, there is limited data on its effects when inhaled. 

Nicotine Level: One of the reasons that vaping is considered safer is that the level of nicotine can be lowered as needed. While traditional cigarettes have a set amount of nicotine, e-cigarette liquid can be purchased with different amounts. This is what makes vaping useful in helping smokers to quit as they can slowly reduce their intake. 

Which is Better: Smoking or Vaping?    

Neither vaping nor smoking are good for your health, however, vaping does have one notable use. Vaping should, ideally, only be used by smokers who are attempting to quit. In this scenario, vaping is less harmful than smoking and can gradually ease nicotine addiction. It should not be used long term in place of smoking or in addition to smoking. 

If you are not currently a smoker, vaping is not a safe alternative. It can still lead to harmful health effects and addiction. If this occurs, you may find yourself going through withdrawals if you attempt to quit vaping. 

Symptoms of Nicotine/Vaping Withdrawal Include but are not limited to:

  • Anxiety and sadness
  • Tiredness 
  • Inability to focus
  • Headaches 
  • Insomnia
  • Increased appetite/weight gain

Will Vaping Help Me Avoid Regular Cigarettes? 

Current research shows that non-smokers who take up vaping are more likely to try other forms of tobacco. Again, the nicotine in vaping liquid is addictive the same way nicotine in a cigarette is addictive. If someone forms an addiction due to vaping, they may crave the increased nicotine levels available in regular cigarettes. 

The Rise of EVALI: The Lung Disease Targeting Young People 

E-cigarette or Vaping Product Use-associated Lung Injury (EVALI) is a lung disease that can affect users of any age but is most common in users under the age of 25. This condition is still relatively new and difficult to diagnose as it is similar to other conditions. Symptoms of EVALI include:

  • Coughing up blood
  • Unintentional weight loss
  • Abdominal pain and diarrhea
  • Chest pain and shortness of breath
  • Headache and dizziness
  • Fever and chills
  • Dry cough and vomiting 

Reducing Your Risk of Developing EVALI

While all vaping has associated risks, many of the most serious and fatal injuries have occurred in users who vaped with black market liquid, THC (tetrahydrocannabinol) and/or modified vaping pens. 

Vitamin E Acetate is sometimes added to certain vaping liquids, especially THC-containing formulas. Vitamin E is typically considered safe for ingestion but may be part of the cause of this issue when inhaled. 

To help minimize your risk of developing this disease, use only approved e-cigarettes and e-cigarette liquids. Avoid using any kind of modified e-cigarette or using liquids that come from informal sources like friends, acquaintances or online e-liquid dealers. 

Treatment and Diagnosis of EVALI 

EVALI can be difficult to diagnose as its symptoms are similar to other diseases. It is also a new phenomenon that has only developed in the past few years. Therefore, doctors and scientists are continuing to study the causes, treatment and long term effects. 

An x-ray is usually needed and your medical history is examined. Antibiotics are often administered to help combat pneumonia symptoms that are also typically present. Steroids are also used. While most patients will start to improve with these treatments, some will relapse and about 25% will require supplemental oxygen. Those who relapsed often continued to have abnormalities on their lungs. Because of this and the newness of the disease, it is difficult to say what the long term effects will be for sufferers of EVALI. 

Long Term Effects of Vaping and Smoking

The chemicals in vaping liquid and traditional cigarettes can both cause harm to your heart, brain, lung and other organs. This can lead to cognitive issues, heart disease, some cancers, breathing issues and more.

Effect on Developing Brains of Teens and Young Adults: Young adults, one of the largest segments of vape users, are at particular risk of long term effects of vaping. Nicotine in vaping liquid can impact the development of a young user’s brain permanently. Long term effects of nicotine on the brain can include but are not limited to:

  • Mood disorders
  • Impulse control issues
  • Difficulty focusing
  • Lowered attention span
  • Poor memory retention
  • Addiction: anyone can become addicted to nicotine, but young adults under the age of 25 may have greater problems breaking this addiction. This is because until the age of 25 your brain is still growing and making connections as you learn. Skills learned during this time in one’s life are easier to retain. The downside to this is that addiction is a kind of learning. Addicting yourself to nicotine at a young age will make quitting more difficult and leave you at greater risk for increased nicotine use and the other long term effects mentioned here. 

Risk of the Unknown

Perhaps the most compelling reason to abstain from vaping is that we cannot confirm that it is safe. We cannot even confirm definitively that it is safer than smoking regular cigarettes in the long term because consumers have only had access to e-cigarettes since 2003. With some diseases requiring decades to form, it is not possible to rule out certain long term effects. Moreover, since e-cigarettes and e-cigarette liquid are not highly regulated, the results will likely vary greatly between users. 

Final Thoughts on Vaping Vs Smoking 

Both vaping and smoking can have serious adverse health effects. While vaping may have benefits in helping users to quit smoking, it is still not a “safe” alternative. In short, if you do not vape already, do not start, and if you do vape, seek help for quitting. 

At BCML, we are here to help you manage your total health. If you are experiencing symptoms of EVALI or would like support in quitting vaping or smoking, our experienced and caring team is here for you. Call 416-929-1900 to schedule a consultation today. 

STIs and STDs: All You Need To Know

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3 out of every 4 Canadians will contract one or more types of HPV (human papillomavirus) in their lifetime. HPV is the most common sexually transmitted infection and different strains can cause genital warts and various types of cancer.  While statistics such as these highlight the importance of safe sex practices and regular testing, HPV and most other STIs and STDs are curable or manageable when caught early. 

Here, we will look at what an  STD is and the difference between STIs and STDs. Having a good understanding about both can help you reduce your risk and destigmatize these often misrepresented conditions.  

What are STDs and What are STIs Exactly?

Here are the details you need to know:

STDs

STDs are sexually transmitted diseases, meaning diseases whose only or primary method of transmission is through sexual contact. Some STDs like HIV, the virus that causes AIDs, can also be transmitted through blood transfusions, birth, and shared needle use. However, the instances of HIV transmission through blood transfusion are now very low as screening methods have become more advanced. 

What causes STDs?

STDs can be caused by viruses, bacteria or parasites.

Viral STDs

STDs caused by viruses include Hepatitis, HPV, and Herpes. Each of these do not have a cure, however a vaccine can protect against some of the most dangerous strains of HPV. 

Hepatitis

There are three types of hepatitis and that primarily affect your liver. If you have any form of hepatitis, the best self-treatment measure you can take is to avoid alcohol and any other substances that put a strain on your liver. Hepatitis A and B both have vaccines along with measures you can take to help manage their effects. 

Hepatitis C does not have a vaccine but can be treated with antiviral medications. These medications can reduce and even eliminate the virus from your blood. However, this is not a guaranteed cure for all patients and the medications are prohibitively expensive in many cases. 

HPV

HPV can be contracted through oral, anal or vaginal sex. There are more than 150 known strains of HPV. For most, a person will not have any symptoms at all and the virus will go away on its own over the course of several months or years. 

If you do experience symptoms, they will be in the form of warts close to the point of infection. Some strains can also cause various types of cancer that may develop years after infection. Regular screening for cancer can help you get treatment early. 

Herpes

Herpes also causes warts and can affect any part of the body. Most commonly they will be found on the genitals, the anus, in or around the mouth and even in the eyes. Currently, there is no cure for herpes but medications can help reduce flare ups.

Note

Both HPV and HIV are also caused by incurable viruses; both of which are considered to be infections, rather than diseases. AIDS is the STD that forms when HIV is allowed to progress. While there is no cure, there are medications that can slow the progression and reduce your risk of passing the infection to a partner. This is another critical reason why it is important to get tested early and often. For HPV, the resulting disease would be considered any cancer that may form due to the infection.

Bacterial STDs

STDs caused by bacteria include gonorrhea, syphilis, and chlamydia. Fortunately, all of these can be treated with medications. However, it is critical that you do seek treatment as they will not go away on their own. When left untreated, a bacterial STD can travel to other areas of the body and cause fertility issues. Syphilis can even damage the heart, eyes and brain if left untreated. 

Parasitic STDs

There are three parasite-caused STDs which include Scabies, Trichomonas vaginalis (Trich) and Pubic lice (sometimes referred to as “crabs” in slang). Trich is easily treated with a single round of antibiotics, however, the symptoms are commonly confused with a UTI if you are not tested specifically for Trich. 

Scabies is diagnosed by visual examination from your doctor who will look for entry points where the parasites have burrowed into your skin.  They can be treated with oral or topical medication prescribed by your doctor.  It is also important that you thoroughly wash your clothing and bedding in hot water to avoid becoming reinfected. 

Finally, Pubic Lice are the most easily visible of the parasitic STDs. These lice are different from the lice that can live in the hair on your head and will, instead, make their home in pubic hair. Medicated body washes are used to kill these lice. Like scabies, these parasites can survive on clothing and bedding which makes it imperative that you wash all of these materials thoroughly. 

STIs

STIs are sexually transmitted infections. Most STDs begin as STIs. Typically, STIs have more treatment options and it is optimal to catch infections early before they can progress. However, it is becoming more common to use STI as the umbrella term for STIs and STDs. The primary reason for this is to help reduce the stigma surrounding STDs. Reducing stigma can help many patients to seek testing and treatment sooner which lowers risk to them and their partners. 

What Are you Legally Obligated to Disclose to a Partner?

While STIs and STDs are primarily a health concern, they can also be a legal one. In Canada, it is illegal to not inform a partner of an STD or STI before engaging in sexual contact. Most cases that have been brought to court pertain to HIV specifically. Other STIs should also be disclosed but prosecutions are rarely for any disease besides HIV. 

Where Can you Get Tested for STIs and STDs? 

The Canadian health system works to make testing convenient for all. Testing is free throughout Canada and can be administered at clinics, many community centres and doctors’ offices. 

For more information on the testing process visit, our How Do I Test for STIs and STDs? Page. If you’re ready to get tested, BCML offers a full spectrum of STD and STI testing including HIV testing. To make an appointment, please call 416-929-1900 today!

How Do I Test for STIs and STDs?

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Sexually transmitted infections and diseases (STIs and STDs) are a common occurrence among sexually active individuals. Fortunately, testing is widely available and affordable or even free across Canada. With early detection, many STIs can be treated more easily and will prevent the spread of diseases. 

Here we will look at common STIs and STDs and what to expect when getting tested. With proper education, it is easier to keep yourself safe and to seek help when needed.

How to test for STIs and STDs

If you have never had an STD test you are not alone in wondering how STD testing works.  Anxiety over testing is also extremely common but should not hold you back from getting the care you need. Diseases are common and many are preventable and treatable with proper knowledge. Let’s look at common questions about the STD testing procedure in Toronto.

Where to Get Tested

Testing is available and free at many locations throughout Canada. Free testing can be found at clinics dedicated to sexual health, walk-in clinics, family doctors’ facilities, community health centres, and other facilities for public health.

When Should You go for STD Testing

When and how to test for STIs and STDs will vary depending on your sexual activity. Ideally, you should start getting tested as soon as you are sexually active. You and your new partner should both get tested again at the start of any relationship. 

If you have multiple partners, you should get tested at a minimum of every 6 months. However, any time you experience any symptoms or you add a new partner whose history you are unsure of, you should also seek STD testing.

STD Incubation Period

Getting tested frequently is important. However, to keep yourself healthy and stop the spread of the disease, you do need to be mindful that diseases have incubation periods. 

For example, chlamydia and gonorrhea will be detectable in a matter of days but hepatitis C can take anywhere from 2 to 26 weeks to make itself known. Certain types of HPV and syphilis may even take years to fully produce symptoms. Again, because of this, you should aim to get tested at least every 6 months when you are sexually active even if you are not experiencing symptoms. 

What to Expect During STD Testing Procedure

Toronto area patients can expect different testing depending on what they are being examined for. A swab test can be used to detect viruses like chlamydia and gonorrhea. 

For these, a swab is taken from either the cervix or throat for women, or from the penis, throat, or rectum for men. Urine tests can also be used to detect these. For hepatitis, syphilis, and HIV a blood test is required. 

How long does it take to get results of STD testing? 

Time for STD testing results can vary. Generally, swab and urine tests will take around a week to return results, while blood tests can take around two weeks. 

Can I continue to be sexually active while waiting for test results? 

If you are experiencing any symptoms such as itching, swelling, warts, or discharge in the genital region, you should not continue having sex. If you do not have symptoms, this is up to your and your partner’s discretion. 

How to Test for STIs and STDs: Myth Busting

You Only Need to Get Tested When you Have Symptoms, Right? False. Many STDs and STIs do not produce symptoms for everyone.  For example, chlamydia which is the most common STI can easily be mistaken for a yeast infection or have no symptoms at all. 

When left untreated, the infection can spread throughout the reproductive organs and cause infertility. Instead, schedule your STD testing whenever you are unsure of your partner(s) status. 

If you use a condom, you don’t need to get tested: False

While condoms reduce the risk of pregnancy and many STDs and STIs, they are not 100%. In particular, they do not offer protection against genital warts or herpes. Both of these conditions are caused by viruses and can exist in areas of the genitals that will not be protected by a condom. 

You can avoid getting an STD by just having oral sex: False

While oral sex carries a lower risk of contracting certain diseases, this is far from a guaranteed solution. In particular, if you have a cold sore, which is a form of herpes, this can be passed to a partner and give them genital herpes. 

You can’t get the same STD twice: False

While some STDs like HIV and herpes are not curable, others can be cured and, subsequently, be contracted again. Gonorrhea and chlamydia are common STDs that people can get multiple times. 

If your partner tests negative for STDs, you don’t need to get tested: False

There are many factors that go into why you should both be tested. Consider the incubation periods we discussed above. You and your partner could have been exposed to different STDs with different incubation periods and they might not be showing, while you are. 

A monogamous couple can’t get STDs: False.

While a monogamous couple certainly lowers their chances of contracting infections and diseases there are still scenarios where this is not guaranteed. For example, if either of you had partners before getting together, you may be carrying an STD with no visible symptoms. HPV is a prime example of this and it also can have a years-long incubation period before causing serious problems.

Even if you and your partner have only had sex with each other, there is still a narrow chance that you may contract a disease. This would happen in two main scenarios: 

  • Either of you contracts a blood-borne STD in a non-sexual way. Blood transfusions and contaminated tattoo equipment, for example. 
  • As we discussed above, oral herpes can be passed to the genitals. Many people have oral herpes simply from kissing an infected person. Even children may contract this from a friendly kiss from a friend or relative. Though this would not be considered sexual contact, it does allow an STD to enter the equation. In this same way, even someone who has never had sex can technically have an STD. 

How to Test for STIs and STDs at BCML 

At BCML we are here to help you manage your total health including your sexual health. We offer a full range of effective and confidential STD and STI testing right at our Toronto clinic. To set an appointment, contact us today at 416-929-1900. Your privacy, safety, and comfort are always our top priorities. 

Ontario Health Insurance Plan: How Does it Work?

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Canada is known for having a national healthcare system, but individual provinces also have health insurance and even private insurance. Ontario Health Insurance Plan or OHIP covers most medical care including emergency and preventative care costs. Notable exceptions to its coverage include dental, vision, and chiropractic services. 

For those outside Canada, there is often the misconception that all healthcare is free. Even residents may not know what services OHIP covers or how it is funded. Here we will take a look at how OHIP works, what it covers, eligibility and other important questions many Ontarians have. 

Is the Ontario Health Insurance Plan Really Free?

OHIP is funded by three sources: The Canadian Government, payroll taxes from employees and taxes paid by Ontario-based businesses. While there is no direct “OHIP Tax,” citizens do essentially pay for healthcare to be available.

Though OHIP may not be as socialistic as some might assume, Ontarians still spend less per person on healthcare than in countries like the United States where there is no universal healthcare. 

Also, OHIP’s system allows for a more equitable distribution of healthcare access. This means a sudden job loss or other financial hardship will not prevent a person from getting medical attention the way it might in the U.S. 

Who is Eligible for the Ontario Health Insurance Plan?

Eligibility for OHIP and medical coverage in Ontario is fairly straightforward in most cases. Anyone who is considered a Canadian citizen, permanent resident or who has a valid work permit is eligible to be covered under OHIP.

What about new residents? 

When an individual first moves to Canada, there is typically a 3 month waiting period before their health care can be covered under OHIP. Supplemental insurance can be purchased to cover this gap.

Citizens who move from another province? 

When you move from another province to Ontario, there will also be a 3 month waiting period until you are eligible for OHIP. However, you will still be covered by your previous province’s insurance during this time.

What about travelling workers?

Typically, to be considered a permanent resident, you must live in Ontario for at least 153 days a year. However, if you have a job that requires you to travel more frequently than this you may need to provide proof you are travelling for your job in order to qualify. 

Are refugees covered?

Refugees and protected persons can often get coverage through the Interim Federal Health Program, a temporary kind of insurance. Coverage with IFHP is similar to provincial healthcare. OHIP coverage may become available if an individual goes through the process of becoming a permanent resident. 

What Services Does OHIP Cover? 

OHIP is designed to provide citizens with urgent and preventative care. This includes doctor visits, hospital stays, certain dental surgeries and costs associated with childbirth. Below you will find a partial Ohip coverage list with some of the most commonly covered and necessary services. 

It is important to note that some services may not be fully covered or will only be covered if they are deemed medically necessary and/or performed in a hospital.  

  • Hospital stays
  • Doctor visits
  • In-hospital dental surgeries
  • In-hospital surgical abortions
  • Diagnostics including x-rays and blood tests.
  • Eye exams
  • Ambulance transportation
  • Mental health services performed by a medical doctor
  • For a complete OHIP Coverage list, visit Ontario.ca.

What is Not Fully Covered by the Ontario Health Insurance Plan?

Dental, vision, prescription and physical therapy costs are some of the least covered by OHIP. However, this is not a blanket statement that applies to every service in these categories.

For example, vision tests are covered for anyone under the age of 19 or over the age of 65. Below are some of the services that may not be fully covered by OHIP. 

Dental and Vision

OHIP will cover certain dental surgeries that are performed in a hospital but will not cover basic services like regular cleanings. Plus, while eye exams are covered, eyewear is not. Many people will either get coverage through their employers or purchase supplemental insurance to cover these costs. 

Cosmetic and Chiropractic

Cosmetic surgery and most medically unnecessary surgeries are not covered. Chiropractic services and some physical therapy may also require complete or partial out-of-pocket payment. 

Mental Health

Canada is a country that recognizes the need for mental health services. Also, most of these mental health services are covered. However, the definition of eligible mental health services covered under OHIP is typically narrowed to only include services provided by medical professionals such as psychiatrists. Other alternative therapy forms may not be covered and you should check for costs before proceeding. 

Physiotherapy

Physical therapy is most widely covered for children/teens and elderly persons. It is also covered for persons recovering from specific injuries and illnesses. 

Eligible physiotherapy will be performed in-clinic and your physician will determine how many sessions you should receive. 

Prescriptions

Prescriptions are typically only covered for persons under the age of 25 and for patients during hospital stays. However, the Canadian government does work to keep the cost of prescriptions affordable by negotiating better rates with drug companies when possible. Private insurance can also be purchased to cover more expensive prescriptions. 

Should You Buy Supplemental Health Insurance? 

While citizens have access to many free and low-cost healthcare services, there are still some that are not covered or not fully covered. Similarly, people who are in their 3 month waiting period for coverage or who do not qualify as permanent residents may also need supplemental insurance.

In many cases, employers will offer insurance to cover things like dental, vision, physiotherapy, prescriptions and other services not fully covered by OHIP. You can also purchase supplemental insurance on your own. 

Supplemental insurance can be beneficial if you need regular access to specialists and therapists not covered under OHIP. Private insurance can help to reduce the costs of prescription eyewear, extensive dental work and prescription medications. 

Does Ontario Health Insurance Plan Cover Pandemic Care Costs?

As of now, OHIP does cover care related to COVID-19. The Pandemic has also caused some changes in OHIP eligibility. Most notably, anyone who has applied for the insurance but is still in their 3-month waiting period for coverage can still get their care for COVID-19 covered. 

However, if you have any doubts about your eligibility or coverage it is best to contact OHIP directly. This is especially true now as the Pandemic is continuing to cause changes to policies. 

Need to Find out if OHIP Covers What You Need? 

While OHIP fully or partially covers many types of care, procedures and treatments there are still some areas that may not be clear. 

If you have questions about your health and what OHIP covers for you, BCML physicians are here to help you navigate your coverage. Contact us to schedule a consultation and we will work with you to get you the best care with maximum coverage.