Which contraceptive should you use?

Contraceptives will only prevent unwanted pregnancies if they’re used properly and consistently. If you’re relying on a method that you often forget to use, that has unwanted side effects, or that is difficult or bothersome to use, you’re likely to stop using it or not to use it all the time. That’s why it’s important to use a method of birth control that suits you and your lifestyle.

When you’re thinking about what kind of contraceptive to use, make sure to consider all the details. Ask yourself questions such as:

  • Which will work best with my schedule and habits?
  • Are there extra health benefits?
  • Which have possible unwanted effects or features?
  • Am I protected against sexually transmitted diseases?
  • Which kind is the most appropriate for my current state of health or medical history?
  • How effective is it?

Barrier options

There are several kinds of birth control that work by keeping the sperm from reaching the egg. These normally have to be applied or inserted just before intercourse and removed afterwards. They include:

  • diaphragms
  • cervical caps
  • vaginal sponges
  • male condoms
  • female condoms

Most of these come in several varieties, and it may be necessary to try a few of any given kind before you find one that has the right fit and sensation. Each has advantages and disadvantages. For example, condoms are the only type of birth control that also offer reliable protection against sexually transmitted infections (STIs). Whichever barrier option of birth control you choose to try, make sure that you are familiar and confident on its proper insertion and use. Your doctor and pharmacist are excellent educational resources for this sort of information.

Be aware that using oil-based products like lubricants, or other products like powders or perfumes may decrease the barrier method’s effectiveness or cause irritation. Ask your doctor or pharmacist if you have any concerns.


Perhaps the best-known method of birth control is “the pill.” These pills are taken once a day. There are many different kinds of birth control pills available. Some use a single hormone and some use a combination; some have lower doses and some have higher doses of estrogen; some have a 28-day cycle of pills and some have 21 or 84 pills; and some have a 7-day period without pills, and others can have less. Talk to your doctor about which would be best for you. You may need to try a few before you find one you feel perfectly comfortable with.

Long-term options

There are forms of birth control that last a long time and only need to be changed very infrequently. If you have a hard time remembering to take a birth control pill every day or if you’re not planning on starting a family in the near future, these birth control options may suit you better:


  • contraceptive patch (changed weekly)
  • hormonal injection or implants (received once every 3 months)
  • vaginal ring (used every 4 weeks)
  • progestin-releasing intrauterine systems (changed once every 5 years)
  • progestin-releasing implant (changed once every 3 years)


  • copper intrauterine devices (lasts 30 months to 10 years)


For people who have no intention of having children in the future, surgery can be a viable option.

For men, the usual operation is a vasectomy. This operation involves cutting or blocking the tube that carries sperm from the testes to the penis. It can now be done in a very short time using local anaesthetic and requiring only a small puncture in the skin, with no stitches needed.

For women, the usual surgery is a tubal ligation: the fallopian tubes are cut, sealed, tied, or blocked, making a permanent barrier between sperm and egg. This is usually done via laparoscopy, using a small incision; the woman can normally go home the same day, but it is a more complicated operation than a vasectomy. Both of these methods are designed to be permanent, but an operation called reanastomosis that unblocks or reconnects the tube(s) can restore fertility in roughly half of all cases.

Other Methods of birth control

Other, “natural” forms of birth control include the use of withdrawal, calendar tracking, basal body temperature and cervical mucus. It’s important to discuss with your doctor which method is most appropriate for you. Depending on your individual circumstance, you may need more than 1 method.

All material copyright MediResource Inc. 1996 – 2023. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Contraception

Did you know that many medical services, as introduction to contraception, can be provided by our nurses, without having to go through a doctor? We’re here for you when you need us most. Book an appointment a nurse at a clinic nearest you.

Book an Appointment

Heart attack: Know the symptoms

The key to surviving a heart attack is getting medical help early – nearly half of all deaths due to heart attack occur within 2 hours of the beginning of symptoms.

Keep in mind that not everyone experiences the same heart attack symptoms to the same degree – some older people and women can experience less obvious symptoms. Some heart attacks come on suddenly, but the vast majority start with mild chest pain and discomfort. Some people experiencing a heart attack are not sure they are having one and may think it’s only heartburn or indigestion. This may result in not seeking medical attention promptly.

Therefore, it’s critical to be familiar with and recognize heart attack symptoms, and to take them seriously.

The following are heart attack warning symptoms:

  • pain or discomfort in the chest, shoulder, arm, back, neck, or jaw that does not go away with rest (in women, discomfort is more common than pain)
  • pressure, heaviness, fullness, burning, or squeezing in the chest
  • shortness of breath
  • nausea and/or vomiting
  • sweating, or cool and clammy skin
  • anxiety or fear
  • light-headedness or sudden dizziness

Women are more likely to feel some discomfort in the chest rather than a sharp pain or tightness. The milder symptoms do not mean that a woman’s heart attack is any less severe than a man’s on.Any symptoms of a heart attack should be taken seriously.- Government of Canada

If you experience these warning symptoms, the Heart and Stroke Foundation suggests doing the following things:

  • Call 9-1-1.
  • Stop all activity and rest (sit or lie down).
  • If you are taking nitroglycerin, take your usual dose.
  • If the 9-1-1 operator advises it, and you are not allergic to ASA, chew and swallow one 325 mg ASA tablet or two 81 mg tablets.
  • Rest and wait for Emergency Medical Services (EMS).
  • Keep a list of the medications that you take on the fridge and in your wallet. EMS will want this information during your care.

Acting promptly may save your life!

All material copyright MediResource Inc. 1996 – 2023. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Heart-Health

Need a cardiology consultation? We are currently accepting new patients. We pride ourselves on our innovation and commitment to providing quality care, including access to cardiology consultations and the following exams: transthoracic echocardiography, stress echocardiography, ambulatory blood pressure monitoring (ABPM), cardiac monitor (HOLTER, 24H) and cardiomemo monitoring. Cardiology consultations are covered by RAMQ. 

Book an Appointment


Menopause is an important health issue. This health feature offers information about menopause: how to tell if you’re entering it, the role of estrogen replacement therapy, and tips on making yourself more comfortable – and staying healthy – as your body adjusts to this new phase.

Menopause – a change of life

All women eventually enter menopause, also known as “the change” or climacteric, which marks the end of a woman’s reproductive life. The stage you go through before actual menopause is called perimenopause, which takes place over about two to eight years (the average is four years) as the body undergoes its hormone-driven changes. This is the time when levels of estrogen, progesterone, and androgen start to decrease. The ovaries gradually stop releasing follicles (eggs), eventually ending your reproductive stage of life. As the body adjusts to this new stage, certain signs and symptoms can occur.

During perimenopause, you might start to experience some of the symptoms of menopause but still have menstrual periods. However, menstrual periods tend to become more and more irregular during this time. You’ve officially entered menopause when your doctor has confirmed that you’re no longer ovulating (there’s a special blood test to check this), or when you haven’t had a single period in a whole year. Keep in mind that, unless your doctor tells you for sure, or until the full year is up, there’s still a chance you can get pregnant.

Women are most likely to be between ages 40 and 60 years when they experience natural menopause – the average age is about 51. If you begin to go through menopause before the age of 40, it’s called premature or early menopause. Menopause occurring after the age of 55 is considered a late menopause.

Some women experience induced menopause, which can happen for one of three reasons:

  • Surgical menopause is triggered by having both ovaries removed during an operation. Women who have hysterectomies (removal of the uterus, therefore no menstrual periods) may or may not have their ovaries taken out, depending on how extensive the surgery was and why it was done.
  • Chemotherapy-induced menopause is brought on by chemotherapy, usually in the course of being treated for cancer. These drugs can affect the ovaries enough to begin the process but, depending on different factors, chemotherapy-induced menopause isn’t always complete or permanent.
  • Radiation-induced menopause can happen while undergoing radiotherapy for cancer. If the ovaries are exposed to enough radiation, they’ll begin to shut down.

The signs and symptoms of menopause – and how severe they are – vary so much from woman to woman that it’s hard to know fully what to expect. Some women go through menopause with only a few hot flushes. Others feel most symptoms to the hilt. Some doctors say that the best guide to knowing how you’ll be affected is to get your closest female relatives – mothers, aunts and grandmothers – to tell you about their experiences.

How can you tell if you’re entering menopause? Some signs include:

  • less frequent or erratic periods, which last for fewer days or have a lighter flow (although some women temporarily experience much heavier flows than usual during perimenopause)
  • hot flushes (or flashes) – bursts of feeling extremely hot, accompanied by sweating – which can range from being mildly annoying to intensely uncomfortable (some women are awakened by night sweats that literally drench their sheets)
  • insomnia or difficulty staying asleep
  • mood changes
  • vaginal dryness and itching
  • decreased libido
  • headaches
  • difficulty concentrating
  • urinary incontinence (leakage)

You should know that irregular bleeding, along with some of these symptoms, might be due to another cause. See your doctor to rule out other possible conditions.

Menopause is a very personal life event. Knowing what to expect can go a long way to easing any concerns or anxieties you may have about going through “the change.” There’s an upside, too: many women after menopause say that they’ve never felt better!

The estrogen question

Is taking estrogen right for you? Is it safe? You’ve probably heard a lot about hormone replacement therapy (HRT), which may be used to treat the symptoms of menopause and, in some cases, to protect against osteoporosis and colorectal cancer. HRT is a controversial topic, especially now that the results of a major U.S. study (the Women’s Health Initiative [WHI] study) have become available. To help sort out the issues, here are some key points that can help you decide what’s right for you.

First, you need to speak with your doctor. You may be interested in taking hormone replacement but it’s not advised for women with certain health issues. This type of therapy isn’t recommended if you have a history of:

  • endometrial or breast cancer
  • blood clots
  • stroke
  • unexplained vaginal bleeding
  • active liver disease

Some women ask why they should take hormones for a perfectly natural stage of life. After all, it’s not a medical condition, is it? True, menopause is a normal state and doesn’t pose any serious health problems on its own. On the other hand, hormone replacement may help certain women in a few ways:

  • by helping to get through the worst of their symptoms, including irregular bleeding, hot flashes, night sweats, difficulty sleeping, mood disturbances, and vaginal dryness
  • by protecting against osteoporosis: the WHI study found that taking a combination of estrogen plus progestin decreased overall fracture risk by 24% (the risk was reduced from 11.1% in women who did not take active medication to 8.6% in women taking estrogen plus progestin) and hip fracture risk by 33%. Estrogen and progestin also increased bone density in the hip by 3.7% (compared with 0.14% in women who did not take active medication). However, because of the risks of HRT, it is not recommended for preventing osteoporosis. It is not routinely recommended for treating osteoporosis except for cases where the benefits outweigh the risks.
  • by reducing the risk of colorectal cancer: the WHI study found that taking a combination of estrogen plus progestin decreased the risk of colorectal cancer by 44%. This translates to six fewer colorectal cancers for every 10,000 women over one year.
  • by reducing the risk of diabetes: in the WHI study, women taking a combination of estrogen plus progestin had a 21% lower risk of diabetes. This translates to 15 fewer cases of diabetes for every 10,000 women over one year. However, HRT is not recommended for the sole purpose of preventing diabetes because of its risks.

HRT also has some risks. Some of the side effects can include:

  • tender breasts
  • nausea
  • abdominal bloating
  • vaginal bleeding
  • uterine cramps
  • weight gain
  • headaches
  • mood swings
  • irritability

Estrogen replacement therapy can increase the risk of endometrial (uterine lining) cancer in women with an intact uterus. This is why women who have a uterus are also prescribed a progestin (such as medroxyprogesterone acetate) to protect them from endometrial cancer. Taking a progestin with estrogen replacement therapy reduces the risk of endometrial cancer to a similar (same or lower) level compared with women who are not taking estrogen replacement therapy.

The Women’s Health Initiative (WHI) study recently found that the use of a certain combination of estrogen and progestin taken in pill form (a combination of conjugated equine estrogen 0.625 mg plus medroxyprogesterone acetate 2.5 mg) significantly increases the risk of breast cancer, heart disease, and stroke. It is important to note that not all forms of HRT have been linked to an increased risk and that these risks occurred with long-term versus short-term usage. It is also important to note that the group of women studied in the trial had an average age of 63 years (with a range of 50 to 79 years), and none had severe menopause symptoms (many had no symptoms at all). Therefore, it is not known to what extent the results will apply to postmenopausal women who have different characteristics than the study group.

Specifically, initial study findings showed that the hormones increased a healthy woman’s risk of:

  • heart disease by 29%
  • stroke by 41%
  • breast cancer by 26%

Although these increases seem high, the actual number of cancers, heart attacks, strokes, and blood clots among the women in the study was small. The study authors say that given the increased risks they found, a group of 10,000 women who took the hormone combination for one year would experience:

  • seven additional heart attacks
  • eight more breast cancers
  • eight additional strokes
  • eight more blood clots in the lungs

The Women’s Health Initiative (WHI) also studied women taking estrogen alone (women who had had a hysterectomy). For every 10,000 women taking estrogen alone, the risks and benefits for these women were (per year):

  • an increased risk of stroke: 12 more cases of stroke
  • possibly, an increased risk of blood clots: six more women with blood clots
  • a decreased risk of hip fractures: six fewer women with hip fractures
  • possibly, a decreased risk of breast cancer: seven fewer breast cancers

As a result of the WHI study, the Society of Obstetricians and Gynecologists of Canada (SOGC) does not recommend that hormone replacement therapy be started or continued for the sole purpose of preventing heart disease, since estrogen plus progestin can actually increase the risk, and estrogen alone does not have any significant effect on the risk. Hormone replacement therapy may be used to treat menopausal symptoms (such as hot flashes), or to protect against osteoporosis and colorectal cancer. However, it is not recommended for women who do not have any menopausal symptoms. The current thought is that the risk of developing breast cancer increases after five years of taking HRT. Because some symptoms of menopause subside after two to three years, a woman should re-evaluate her need for HRT each year. The SOGC recommends that the lowest effective dose of HRT should be used for the shortest period of time needed.

Since each woman’s health history is different, it’s important that you openly discuss your concerns and needs with a doctor. Together, you can weigh the pros and cons of hormone replacement. If you decide not to take hormone replacement therapy, there are other treatment options for menopausal symptoms and osteoporosis. If you decide to go ahead with hormone replacement, you’ll be prescribed a treatment plan that’s tailored for you. Hormone replacements come in many forms and dosages, including pills, patches, gels, vaginal preparations, and injections.

The first time hormone therapy is suggested might be while you’re still in perimenopause. Some doctors recommend low-dose contraceptive pills to help regulate the menstrual cycle as it becomes more irregular. It’s convenient, but the drawback is that you can’t tell if your period has stopped completely or not.

It’s only natural

Whether or not you choose hormone replacement, other methods may help ease some of the discomforts of perimenopause and menopause. Because not all women are affected the same way, finding the right solution is sometimes a matter of trial and error.

For hot flashes:

  • stop smoking
  • avoid caffeine and alcohol
  • get regular exercise
  • decrease body mass index (BMI) if your doctor says it’s too high
  • reduce stress either by relaxation, biofeedback, meditation, or some other method you find soothing
  • lower your room temperature
  • dress in layers to reduce body temperature as needed

For insomnia:

  • don’t eat a heavy snack before bed
  • avoid caffeine and alcohol
  • make your bedroom as inviting and “sleepy” as possible; don’t use your bedroom for anything other than sleeping or sexual intimacy
  • develop a calming bedtime routine every night
  • avoid taking daytime naps

For problems with urinating too often or having episodes of urinary incontinence (leakage):

  • avoid hard alcohol or any liquid that triggers the need to urinate such as coffee, tea, or beer
  • practice Kegel (pelvic) exercises daily
  • wear a pad if you’re afraid of being caught in an embarrassing situation

Don’t limit your fluid intake to keep from urinating unless you’re advised to do so by your doctor. Dehydrating yourself will make menopausal symptoms worse.

For decreased sexual desire:

  • if you don’t have enough vaginal lubrication, try using a water-soluble gel
  • set a sexy mood by wearing that special gown, lighting candles, or playing romantic music

It also helps to let your partner know how you’re feeling, so that you can both take the time to get in the mood.

You can also speak to your doctor about highly effective non-hormonal medications to treat your menopausal symptoms. For example, venlafaxine or clonidine may reduce the frequency of your hot flashes, and medications called selective serotonin reuptake inhibitors (SSRIs) may help control mood swings.

If you’d like to try herbal remedies for some of your symptoms, check with your doctor or pharmacist to be sure that these don’t interact with any medications you are taking and that you don’t have any medical conditions where these herbal remedies should be avoided.

Staying healthy after menopause

It used to be that the average lifespan of a woman in North America only extended into the early 60s. Now that women are living into their 70s, 80s and beyond, this brings a whole new dimension to women’s health.

The main health concerns after menopause are osteoporosis, heart disease and breast cancer. We’ve been told that hormone replacement can help lessen the risk of osteoporosis, but if you’re one of the women who can’t take the drugs or have decided not to, there are other ways to help protect yourself. These measures benefit all women – whether they’re on hormone replacement or not.

To protect against osteoporosis

  • Osteoporosis Canada recommends taking 1,200 mg of calcium per day, along with 800 to 2,000 IU of vitamin D daily if you are over 50 years old. Be sure to mention if you’re taking any kind of supplement to your doctor.
  • Stay active. If you haven’t already and can do so, begin a weight-bearing exercise program. Studies have shown that weight-bearing exercises encourage healthy bones and prevent bone mass loss. If you can’t participate in a regular program, simple walking routines or gardening also help. If you’re one of the many women with joint pain, perhaps swimming would be a good option for you.
  • Stop smoking, avoid caffeine and eat a well-balanced diet with plenty of calcium and vitamins.

There are also medications specifically designed to treat bone loss, so you may want to discuss this with your doctor if needed. As well, you may want to go for a bone-density measurement test to get a baseline measurement. This way, you and your doctor will know where you stand and if you’ll need regular monitoring.

In the past, hormone replacement therapy was also used to protect against heart disease. However, a major clinical study, the Women’s Health Institute (WHI) study, has found that instead of preventing heart disease, long-term use of hormone replacement therapy actually increases the risk. For this reason, it is no longer recommended that women take hormone replacement therapy for the sole purpose of preventing heart disease. Therefore, it’s more important than ever for women to find other ways to reduce their risk of heart disease.

To protect against heart disease

  • Stop smoking. Yes, you’ve heard it before, but here’s yet another good reason to quit. Cigarettes increase your risk of stroke and heart disease.
  • Eat a healthy, balanced diet that is low in saturated fats.
  • Watch your blood pressure. Have it checked regularly and follow your doctor’s recommendations for lowering it, including medication if needed.
  • Watch your weight. Obesity contributes to heart disease.
  • Get physical. Move around to keep your heart healthy.
  • Try to limit your stress levels.

If you’re in perimenopause, or have already entered menopause, it’s important to take stock of your health status, especially if you’re aware of conditions for which you may be at high risk. Talk to your doctor about the options available to keep you healthy. Information about taking preventive steps can help you fully enjoy the many years to come after menopause.

All material copyright MediResource Inc. 1996 – 2022. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Menopause