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A discussion of oral contraceptive methods for birth control, featuring the estrogen-free progestin based Mini-Pill. Learn about how the mini-pill works to prevent. Some testosterone side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Contraindications and Adverse Effects (taken from Current Medical Diagnosis and Treatment: a major medical text) Oral contraceptives have been. An internet search on Depo withdrawal turns up multiple online postings, suggesting that some women are concerned about or report experiencing a number of. One method of contraception is the patch. The contraceptive patch is a sticky patch, a bit like a nicotine patch, measuring 5x. It delivers hormones into your body through your skin. In the UK, the patch's brand name is Evra. It contains the same hormones as the combined pill, and it works in the same way. This means that it prevents ovulation (the release of an egg); it thickens cervical mucus, which makes it more difficult for sperm to travel through the cervix; and it thins the womb lining, making it less likely that a fertilised egg will implant there. At a glance: facts about the patch. When used correctly, the patch is more than 9. Each patch lasts for one week. You change the patch every week for three weeks, then have a week off without a patch. You don't need to think about it every day, and it's still effective if you vomit or have diarrhoea. You can wear the patch in the bath, in the swimming pool and while playing sports. The patch can increase blood pressure, and some women get temporary side effects, such as headaches. The patch may protect against ovarian cancer, womb cancer and colon cancer. The patch may not be suitable for women who smoke and who are 3. The patch does not protect against sexually transmitted infections (STIs), so using a condom as well will help to protect you against STIs. How it works. How you use the patch When the patch starts to work. What to do if the patch falls off. What to do if you forget to take the patch off Bleeding in the patch- free week How you use the patch. You can use the contraceptive patch on most areas of your body, as long as the skin is clean, dry and not very hairy. This is known as your patch- free week. During your patch- free week you will get a withdrawal bleed, like a period, although this may not always happen. After seven patch- free days, you apply a new patch and start the four- week cycle again. Start your new cycle even if you are still bleeding. You should not stick the patch on: sore or irritated skin anywhere it may get rubbed off by tight clothing your breasts When you first start using the patch, you can vary the position every time you use a new patch to reduce your risk of irritation. When the patch starts to work. The licence for the patch states that if you start using the patch on the first day of your period, it starts working straight away. This means you can have sex without getting pregnant. The Faculty of Sexual and Reproductive Healthcare guidance states that if you start using the patch in the first five days of your menstrual cycle, you will be protected and won't need to use additional contraception. If you start using it on any other day, you need to use an additional form of contraception, such as condoms, for the first seven days. You can talk to your doctor or nurse for more information about when the patch will start to work, and whether you need to use additional contraception. What to do if the patch falls off. The contraceptive patch is very sticky and should stay on. It should not come off after a shower, bath, hot tub, sauna or swim, or after exercise. If the patch does fall off, what you need to do depends on how long it has been off, and how many days you had a patch on before it came off. If the patch has been off for less than 4. If the patch has been off for less than 4. If this is the case, you do not need to use additional contraception. If you have had a patch on for six days or less before it falls off, you may not be protected against pregnancy and should use additional contraception, such as condoms, for seven days. If the patch has been off for 4. If you had unprotected sex in the previous few days, you may need emergency contraception. See your GP, nurse or local sexual health (GUM) clinic if you are concerned. What to do if you forget to take the patch off. If you forget to take the patch off after week one or two, what you need to do depends on how long you have forgotten it. If it has been on for: Less than 4. Continue to use your patch as normal, changing it on your normal change day. You don’t need to use any additional contraception and you are protected against pregnancy. This is now week one of the patch cycle and you will have a new day of the week as your start day and change day. Use another method of contraception, such as condoms, for the next seven days. Ask your doctor or nurse for advice if you have had sex in the previous few days and were not using a condom, as you may need emergency contraception. If you forget to take the patch off after week three, take the patch off as soon as possible and start your patch- free break. Start a new patch on your usual start day, even if you are bleeding. This means that you will not have a full week of patch- free days. You will be protected against pregnancy and do not need to use any additional contraception. You may or may not bleed on the patch- free days. What to do if you forget to put a patch on after the patch- free week. There is no specific research on what happens if the patch- free week is longer than seven days. The patch works in a similar way to the vaginal ring and the combined pill, and advice for extending the patch- free week is based on what is known about the vaginal ring and combined pill. If you forget to put on a patch at the end of the patch- free week, put a new one on as soon as you remember. If you put the patch on 4. If you put the patch on more than 4. Ask your doctor or nurse for advice if you have had sex in the patch- free interval, as you may need emergency contraception. This is nothing to worry about if you have used the patch properly and have not taken any medication that could affect it. See your GP or nurse for advice if you are worried, or do a pregnancy test to check if you are pregnant. If you miss more than two bleeds, get medical advice. Who can use the patch most GP surgeries community contraception clinics some GUM clinics sexual health clinics some young people's services Find a clinic near you. The contraceptive patch is not suitable for everyone. If you are thinking of using it, your doctor or nurse will need to ask you about your health and your family’s medical history, to make sure the patch is suitable for you. It is very important to tell them about any illnesses or operations you have had, or medications you are currently taking. Conditions and circumstances that may mean you should not use the patch include: you are pregnant or think you may be pregnant you are breastfeeding you smoke and are 3. St John’s Wort or medicines used to treat epilepsy, tuberculosis (TB) or HIVYou will also not be able to use the patch if you have (or have had) any of the following conditions: thrombosis (blood clots) in a vein or artery a heart problem or a disease affecting your blood circulatory system (including high blood pressure) migraine with aura (warning signs) breast cancerdisease of the liver or gallbladder diabetes with complications, or diabetes for more than 2. Advantages and disadvantages of the patch. If it is used properly, the contraceptive patch is more than 9. This means that if 1. Other advantages of the patch are: it is very easy to use and does not interrupt sex unlike the combined oral contraceptive pill, you do not have to think about it every day – you only have to remember to change the patch once a week the hormones from the contraceptive patch do not need to be absorbed by the stomach, so it is just as effective even if you vomit or have diarrhoea like the pill, it tends to make your periods more regular, lighter and less painful it can help with premenstrual symptoms it may reduce the risk of ovarian, womb and bowel cancer it may reduce the risk of fibroids, ovarian cysts and non- cancerous breast disease Some women may find that the contraceptive patch has some disadvantages and may wish to use a different form of contraception. Some potential disadvantages of the patch are that: it may be visible it can cause skin irritation, itching and soreness it does not protect you against STIs, so you may need to use condoms as well some women get mild temporary side effects when they first start using the patch, such as headaches, nausea (sickness), breast tenderness and mood changes; these side effects usually settle down after a few months bleeding between periods (breakthrough bleeding) and spotting (very light, irregular bleeding) is common in the first few cycles of using the patch; this is nothing to worry about if you are using the patch properly, and you will still be protected against pregnancy Some medicines can make the patch less effective. If you are prescribed new medicine or are buying an over- the- counter medicine, ask the doctor or pharmacist for advice. You may need to use an extra form of contraception while you are taking the medicine, and for 2. Risks of using the patch. There is a very small risk of some serious side effects when you use a hormonal contraceptive, such as the contraceptive patch or combined pill. Blood clots. The patch slightly increases your chance of developing a blood clot, which can block a vein (venous thrombosis) or an artery (arterial thrombosis, which may lead to a heart attack or stroke). If you have had a blood clot before, do not use the patch. Your risk of blood clots is higher during the first year of using the patch. Your risk is also higher if: you smoke you are very overweight you are immobile (unable to move) or use a wheelchair you have severe varicose veins a close family member had a venous thrombosis before they were 4. International programs for the detection of breast. The benefit of early breast cancer detection is the foundation for programs around the globe to reduce.Prostate cancer detection; Screening programs. Breast cancer screening. International Alliances. 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French critics have been happy to compare Moulessehoul with another Algerian, Albert Camus. As might be expected from a soldier who survived the vicious Algerian civil war of the 1. Moulessehoul has an interest in the grand political conflicts now troubling the Muslim world. The Impac- shortlisted The Swallows of Kabul (2. Taliban in Afghanistan. The Attack, published in France as L'attentat in 2. Israel who are of Arab blood. These are the descendants of the Arabs who stayed behind rather than go into exile at the formation of the Israeli state in 1. They have suffered discrimination and mistreatment but have also prospered, and are now squeezed between an embattled Jewish state and their insurrectionary fellow Arabs in Gaza and on the West Bank. Amin Jaafari is a hard- working, able and successful surgeon at a busy Tel Aviv hospital, a sort of professional show pony, . Two generations away from his Bedouin origins, he is well off, popular with his Jewish colleagues, and, though childless, devoted to his wife Sihem. The book opens with Amin taking charge of the chaos in the emergency room after a suicide bomber attacks a fast- food restaurant in the Hakirya district of Tel Aviv, killing 1. Though one of his Jewish patients spits in his face, and he is stopped and searched four times by Israeli coppers on the way home, Amin only wakes up to his own misfortune (and the reader to the black dramatic irony) when he learns that Sihem has been killed in the bombing. More to the point, her wounds are consistent with those found on suicide bombers. At first, Amin refuses to believe that Sihem could have committed such an atrocity. He expects her to return soon from visiting her old grandmother in Kfar Kanna. Disbelief gives way to horror when Sihem's last letter, posted from Bethlehem, turns up in his post box. Amin's life, ambition, values and friendships disintegrate. He descends into a nightmare of drink and perplexity in which he examines every assumption of his life, nationality and marriage. A Jewish colleague, Kim Yehuda, a sister of mercy if ever there was one, calls Amin back from the brink. He retraces Sihem's last journey from Tel Aviv to Bethlehem and back again. Like the hero of the noir thrillers that Moulessehoul seems to admire, Amin is repeatedly beaten up: by the Shin Bet, his Tel Aviv neighbours and Palestinian militants in the West Bank towns of Bethlehem and Jenin that were under siege by the Israeli army. He is lectured by imams and would- be martyrs. He clings to both his professionalism and his humanity. Between Amin and the reader, there falls the shadow of that other doctor in Camus' La Peste (1. His Arabs strike heroic poses. There is none of that peculiarity of place, person and history that you find in an Israeli Arab writer such as the late Emile Habiby. As far as I know, only one suicide bombing has been carried out by an Israeli Arab and that was by a man in Nahariya in 2. Sihem's motivations are a riddle, and the Arabs created to explain them are mere incorporations of political postures. Fortunately, the novelist reasserts himself. The Israeli army bulldozes the house of Amin's great- uncle; and his cousin, Faten, who like Sihem is childless, goes off on her way to some dreadful act of terror and martyrdom. For an instant, or less, one sees an A- to- B in which A is an ordinary, virtuous woman and B is a devastated caf.
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