April 13, 2012
by: Naeemah Ghafur, M.D.
Based on listener questions asked on April 11, 2012 broadcast, Dr. G. has decided to share some useful information for the listeners. Should you have any additional questions, please post them below and Dr. G. will comment accordingly.
Patient Assistance Programs
I would recommend signing up for CVS, Walgreens or WalMart’s Prescription Plans. The prices for medications under these plans are considerably lower than they would be even for people who are insured. In fact, I hardly ever use the insurance prescription plan for my own family because the co-pay for meds is $10 for a one month supply. By paying $35 at Walgreens for their plan, I can get a 3 month supply of a generic medication for $12. Another option is Costco. They’re prices are ridiculously low compared to local pharmacies.
Condoms are usually made of latex or polyurethane. If possible you should use a latex condom, as they are slightly more reliable and in most countries they are most readily available. Latex condoms can only be used with water based lubricants, not oil based lubricants such as Vaseline or cold cream as they break down the latex.
Polyurethane condoms are made from a type of plastic. They are suitable for the small number of people who are allergic to latex. Polyurethane condoms are thinner than latex condoms, and so can increase sensitivity. However they are more expensive than latex condoms and slightly less flexible so more lubrication may be needed. Both oil and water based lubricants can be used with these.
It’s not clear whether latex or polyurethane condoms are stronger. However, with both types the likelihood of breakages is very small if used correctly.
(Shaun, I’m still looking for another alternative to the lambskin)
As stated during the show, I would recommend the listener attempt to figure out whether or not she truly is allergic to semen. I suggested that it may be the condom or lubricant. Here is an interesting article regarding treating a semen allergy. I find WebMD very helpful for patients. Sponsored by Medscape, it is a reputable source. Plus, the slideshows are awesome!
All sexually active women 24 years of age or younger (including adolescents), are at increased risk for chlamydial infection. In addition to sexual activity and age, other risk factors for chlamydial infection include a history of chlamydia or other sexually transmitted infection, new or multiple sexual partners, inconsistent condom use and exchanging sex for money or drugs. Risk factors for pregnant women are the same as for non-pregnant women.
Prevalence of chlamydial infection varies widely among patient populations. African-American and Hispanic women have a higher prevalence of infection than the general population in many communities and settings. Among men and women, increased prevalence rates are also found in incarcerated populations, military recruits, and patients at public sexually transmitted infection clinics. (via US Preventive Services Task Force)
The US Preventive Services Task Force studies the latest evidence and makes recommendations based on their findings. It is updated every couple years depending on the information studied. Cervical cancer screening recommendations were just updated this year. The information/guidelines from the USPSTF is what most doctors in most specialties use in addition to their own specialty governing bodies.
The information is somewhat lengthy but not difficult to understand. In fact, I would recommend reading it because it gives you a better understanding of why certain organizations make the policies they do. It isn’t perfect and it isn’t set in stone. These are only recommendations.
“The Mammogram Issue“
This is a sticky subject for me personally because I know of people who were diagnosed with breast cancer at 36-37 years of age and were deceased by 40. The bottom line is that if someone is concerned about their health and wants a particular test done and the insurance company refuses they will have to pay for it themselves. There are many radiology groups that offer lower cost exams. For example, instead of the average $150 for a mammogram, they may charge $75 for lower income individuals. You just need a doctor’s order.
American College of Obstetricians and Gynecologists Guidelines for Pap:
Where to get low to no cost care:
(This is in Southern California which has one of the best and largest health care safety nets. However, in most major metropolitan areas there are similar organizations
Naeemah Ghafur, MD
Wife and Mother of two, Dr. G. has a B.S. in Biology and received her M.D. at the University of Southern California Keck School of Medicine.