Category Archives: STDs

Sexual Assault


Last excerpt from Modern Birth Control Booklet. Reference information included.

Photo: Bradem Guneum,

Sexual Assault includes forced or coerced sexual behavior or contact that happens without consent. Child molestation, incest (sexual assault by a family member), fondling and unwanted touching through clothing or beneath clothing, rape, attempted rape, sexual harassment or threats, are all included.  Additional illegal acts: voyeurism (peeping, watching private sexual acts without consent), exhibitionism (self-exposure in public by either men or women), forcing someone to pose for sexual photos. Half of all women have experienced some type of sexual assault.

Rape is common and often not reported. Approximately 23 million women in the U.S. have been raped: 1 in 6, half of them under the age of 18. Male rape is less common, but reported by about 2 million men, about 1 in 33.

Sexual assaults are most often committed by someone the victim knows: friends, acquaintances, relatives, dates or a partner. Stranger rapes are less common. Many cases of sexual abuse of children go unreported. When this occurs, the child is abandoned to the pedophile without hope of escape. Reporting to law enforcement and child protective services is a legal requirement and may save a life.

Definition of Rape

The U.S. Department of Justice announced a revision of the Uniform Crime Report’s (UCR) definition of rape in 2012. Without a comprehensive definition, reporting is variable and inaccurate. In the UCR, the definition rape is: The penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim.

The revised definition includes situations when the victim is not capable of giving consent due to temporary or permanent mental or physical disability. State statutes still determine the ability of a victim to give consent with specific details related to age, age differences between the victim and perpetrator and if drugs were used to incapacitate the victim.

Legal Consent

You must:

* Be of age to consent (16 – 18 years old depending on state laws).

* Not be impaired mentally or physically (due to drugs, alcohol, illness or disability).

* Not be threatened (re: job, physical harm, rumors), forced, coerced or manipulated into agreement.

What to Do if Assaulted:

* Find a safe place as fast as you can. If you remain in danger, call 9-1-1.

* Do not wash, shower or change clothes.

* Do not change anything at the scene of the attack.

* Bring a change of clothing with you if possible and go to the nearest hospital ER immediately for an exam and evidence collection. (NOTE: Most physicians do not have rape kits and are not prepared to do forensic valuations. ERs are required to do the exam or refer you to a facility prepared to do so.)

Evidence Collection

* A doctor will perform an exam and document a medical report.

* Either the doctor or a sexual assault forensic examiner (SAFE – often a nurse) will use a rape kit to collect evidence including: swabs of semen, skin swabs, hair samples, saliva and fibers. Your clothing will be collected as evidence and bagged.

* If you believe you were drugged, tell the ER staff so proper testing will be performed. Drugs include: Rohypnol, gamma hydroxybutyrate (GHB), alcohol and other sedatives.


Pelvic cultures are done to document STDs. Blood test baselines record status related to existing disease such as HIV, syphilis, hepatitis and other health issues.

It is customary to treat sexual assault victims with preventive antibiotics that cover most STDs, and to provide Emergency Contraception for women of childbearing age.

Appointment for proper follow-up must be arranged to determine need for further testing, treatment or counseling.

Each case is different. Treatment depends on injuries, psychological state, safety after exam, and personal or family support. Some victims require hospitalization and sedation. Rape injuries can require surgical repair. Safe-house placement may be necessary, or discharge to protective family and friends.


Police reports are essential to prosecute the perpetrator. Officers will come to the ER to obtain a report. Some victims are afraid to report a rapist. The decision to “press charges” is up to the state. Prosecutors may move forward even when the victim does not want to be involved in prosecuting.

For additional legal information see the website for Rape Abuse and Incest National Network (RAINN):

Local police departments often provide referrals to victims of violence. Safe houses are sometimes available for victims who remain at risk from the perpetrator.


Following a sexual assault most people are left feeling vulnerable, frightened and anxious. Many symptoms are reported. Sometimes issues persist for months or longer. Symptoms of Post-Traumatic Stress Disorder may occur: high anxiety, fear, hypervigilence, poor sleep and depression. Later, abuse of drugs and alcohol may occur along with erratic behavior.

Counseling is very important and should be obtained immediately to begin healing after the traumatic event.

Help Sources

General information:

National Sexual Violence Resource Center 1-800-656-HOPE

Sexual Assault Online Hotline

The Gift of Fear Survival Signals that Protect Us from Violence   Author: Gavin De Becker

Reducing Sexual Assault Risk

Preventing assault may not be possible, but there are steps that could reduce your risk.

* Do not walk alone or walk along talking on your phone or listening to music.

* Be aware of your surroundings and stay in brightly illuminated areas.

* Carry a small canister of pepper spray, readily accessible. (Check local laws.)

* Walk to your car rapidly, get in and lock the doors.

* If you are attending a party, go with at least one friend and stay together. Look out for each other. If people are drinking and you begin to feel unsafe, leave.

* Don’t drink from a punch bowl. Watch your drink at all times to avoid being drugged.

* Make a phone call for help.

* Trust your instincts.

Contraceptive Summary

The most effective contraception is abstinence. For most adult men and women that is not an option. For young people who have not yet reached maturity, it is best to abstain from sexual contact until you are sure and fully understand reproduction and contraception.

Unplanned pregnancies in teens are often related to situations where drugs and alcohol were involved and decisions unsound. In drug environments, promiscuity and inappropriate sexual interactions occur more often. This increases risk for sexual assaults and so-called date rapes.

Finding you are pregnant, unmarried and unable to support yourself, places you in an untenable situation. Your future has changed. If you plan ahead, are educated, and understand your actions have consequences, you are ready to make life decisions. That is true for any age.

Because of the high risk of venereal disease with unprotected sex, one action may not just change your future plans, you may find yourself with an incurable disease. Acting responsibly and always using a condom along with an additional contraceptive of choice, you are taking responsibility for your actions.

A woman should be in control of her body and with the information in this pamphlet, I hope both men and women are better prepared to make decisions in their best interest.

Men need to realize “no” means no. Any under-age, drug or alcohol impaired female is not legally capable of giving consent. Intercourse without consent is rape. Rape conviction can carry a long prison term and you will be required to register as a sex offender.

Some contraceptive options are too costly for many people to consider unless they are partially covered by insurance. Some of the more expensive choices are the most convenient, but there are many inexpensive effective choices. Condoms, both male and female, used with spermicide are inexpensive, readily available and when used appropriately are effective contraceptives and reduce STD exposure. The contraceptive sponge is also inexpensive and when used with a condom, effective.

Insurances often cover birth control evaluations and contraceptives. If you compare prices, you will find the cost of birth control pills and contraceptive options vary depending on the source. Large national pharmacies tend to have lower prices. The prices listed in the pamphlet are estimates based on many sources.

Money, convenience, comfort, safety, and long term health are all important factors in contraceptive decisions. Hormonal products are effective and safe for most women but carry some health risks that need to be considered and discussed with your health practitioner.

If you have difficulty seeing a physician, consider choosing a nurse practitioner as your primary care provider.

Miscellaneous References

Click to access female-condom-fact-sheet.pdf

Publications by Betty Kuffel, MD

Author’s page link to all books on Amazon, Betty Kuffel Author


Sexually Transmitted Disease – STD Sexually Transmitted Infection – STI



Finding you are infected with a sexually transmitted disease is a life-changing event. Most STDs require antibiotics or an antiviral for a genital herpes outbreak. Submitting yourself to such an exam may seem degrading but is very important. Serious complications of pelvic inflammatory disease can require hospitalization and intravenous antibiotics with the longterm outcome of possible sterility in women, rapid evaluation and treatment is important. For both men and women, stopping the spread of disease to others is essential.

Anyone diagnosed with a sexually transmitted disease should be tested for HIV.

Family doctors, urgent care centers, state health departments, community and VD clinics and Planned Parenthood clinics are all good choices for evaluation and treatment. Some of them provide free testing and treatment. Both partners should be tested and often both require treatment.

Remember, condom use can reduce your risk for getting an STD.

The most common cause of a vaginal discharge or fishy malodor is BV, resulting from numerous bacteria having replaced the Lactobacillus normally found in the vagina. The cause is unknown but it is seen more often in women who have multiple sex partners, don’t use condoms and douche (wash out the vagina). It is also seen commonly in women who have HIV. Treatment: Oral metronidazole or antibiotic intravaginal gel or cream. Male partners are not treated.

Chlamydia – Most reported infectious disease in the U.S.

Chlamydia trachomatis bacteria cause this inflammatory disease affecting men and women. Symptoms may not occur for several weeks after exposure. But, as the disease progresses in women, it spreads from the vagina into the cervix and uterus, extending into the fallopian tubes causing pelvic inflammatory disease (PID). Yellowish vaginal discharge and pain with intercourse are common symptoms.

Infertility occurs when the tubes scar and close the narrow passage for eggs and sperm. If an egg travels into the tube and is fertilized, but the fertilized egg is unable to migrate into the uterus, it grows within the tube resulting in a tubal pregnancy. The enlarging fetus causes pain, rupture of the tube, and sometimes death of the mother due to hemorrhage. Treatment is usually surgical removal of the tube and the nonviable fetus.

Men may have no symptoms, but can still spread the disease. Later, they may develop urethritis (burning discomfort with urination) and a discharge from the penis. Some men develop epididymitis (painful inflammation in a testicle). Proctitis (inflammation of the rectum) also occurs causing pain, discharge and bleeding.

The infection can spread to the eyes resulting in conjunctivitis due to touching with contaminated fingers. Some people develop arthritis. Newborns may develop eye infection with Chlamydia by passing through an infected birth canal.

Treatment: Antibiotics. No sexual activity for one week after completing treatment to avoid spread to a partner. Retest following treatment to assure a cure. Antibiotics do not reverse tube scarring.

Another Chlamydia STD is lymphogranuloma venereum (LGV). It is common in Africa, but has spread to Europe and the U.S. LGV begins with a painless genital ulcer (an open sore), then days to weeks later, lymph nodes in the groin enlarge and become painful. It is most common with men who have sex with men (MSM) but is also seen in women. Antibiotic treatment. Sometimes surgery is needed to drain the lymph nodes.

Gonorrhea (GC) – The second most reported infectious disease in the U.S.

Neisseria gonorrhoeae bacteria are easily passed by sexual contact and spread to others. More than 800,000 new cases are diagnosed each year in the U.S.

Discomfort with urination and a thick yellow discharge from the penis are the symptoms that usually bring men to see a physician for treatment. In women, the infection may cause no symptoms until complications with infection migrating into the tubes and abdomen occurs – PID. This infection can cause tubal scarring and lead to infertility and tubal pregnancies.

Gonorrhea may infect the throat from oral sex. This problem is more difficult to treat. Serious blinding eye infections can occur in both adults and newborn infants. Sexually abused children are also found to have GC.

Treatment: The diagnosis is made by cultures and treated with antibiotics. Cure is possible, but resistant organisms have developed making common treatments less effective. Additional medications, sometimes with dual therapy are needed. Sex partners should be referred for evaluation and possible treatment.

Unfortunately, GC infection can be carried throughout the body in the blood (Disseminated Gonococcal Infection). When this happens skin lesions pop up and joints become painful. Sometimes meningitis, infection inside the heart, and around the liver occur. Hospitalization and treatment by an infectious disease expert is needed.

Genital Herpes

Two herpes simplex viruses spread by genital infection: Type 1 (HSV-1) and Type 2 (HSV-2). Transmission may occur from an infected partner who has no visible sores and is unaware he or she is infected. The disease is very common. More than three-quarters of a million people get new herpes infections each year.

Both types cause painful blisters and ulcers. Although the skin lesions are usually on the genitals, the viruses can spread and infect buttocks, groin, hands and eyes. Blindness and even encephalitis (brain inflammation) and meningitis (inflammation of brain lining) can occur. In pregnant women who have genital lesions at the time of delivery, C-section delivery of the infant is done to prevent potentially fatal HSV transmission to the child.

Condom use does not always prevent spread of HSV because lesions may be outside the areas covered by condoms. Genital herpes infection is incurable and periodic flares of the disease occur over a lifetime. Antiviral medications can shorten outbreaks. Daily antiviral medication can reduce the possible transmission to sex partners. To avoid HSV infection, abstain from sexual contact or be in a longterm relationship with one partner who has been tested and is uninfected.

Genital Warts (Caused by HPV – Human Papilloma Virus)

Genital warts are caused by numerous HP Viruses. HPV types 16 and 18 are associated with high-grade squamous intraepithelial cancerous lesions of the cervix, vagina, penis, anal and oropharyngeal (mouth and throat) cancers.

Most of the HPVs do not stimulate cancerous changes in the tissue, however they cause growths along the vaginal opening, inside the vagina, on the cervix, beneath the foreskin of the penis, on the scrotum and around the anus. Some infections resolve without treatment, others persist despite multiple interventions. The warts may be small and flat, but may resemble cauliflower flowerets and dangle from stems. Warts may be painful or itchy. These lesions are highly contagious.

Treatment: Many different treatments are used and many physician visits are necessary. Surgical removal, cryotherapy (freezing), topical acid treatments and laser therapy may be necessary. Cure is unlikely.

Always use condoms to prevent this disease. Partners of infected people should be warned and evaluated by a physician. Women who have had HPV require long term monitoring for cervical cancer.

HPV immunization recently became available and it prevents infection. It is the only immunization against a cancer. HPV infections of the cervix and throat are known to be associated with cancer.  To be effective it must be given before becoming sexually active.


Treponema pallidum is a bacterium that causes a serious disease beginning in Primary Syphilis with painless infectious ulcers, often on lips or genitals.  This is the highly contagious time. The next stage, Secondary Syphilis, produces a rash, more lesions inside the mouth and on genitals, and swelling of lymph nodes. In the final stage, Tertiary Syphilis causes heart and neurologic symptoms including meningitis, stroke, altered mental function, hearing and eye problems. Eventually, numbness and loss of balance make life miserable. Babies born to infected women have congenital syphilis with distorted features and mental deficiency.

A microscopic evaluation of material from the ulcers may show tiny snake-like bacteria in the Primary stage. These spirochetes cannot be cultured, but in later stages blood serum testing is helpful. The Venereal Disease Research Laboratory test (VDRL) or the Rapid plasma Reagin (RPR) will likely be positive. Newer tests use specialized processes. Interpretation of the tests and treatment are difficult and best done by experts. Sometimes spinal fluid must be tested.

Treatment: Early treatment with penicillin intravenous can be curative. In later stages, treatment is longer. A specific form of penicillin, Penicillin G, must be used because it crosses the blood-brain barrier where others do not penetrate the brain and should not be used. Syphilitic pregnant women can be treated with Penicillin G. It is important to follow guidelines for contacting and possibly treating sex partners. Anyone with syphilis should be tested for all STDs and HIV.

Hepatitis Overview

Many forms of hepatitis (liver inflammation) are not contagious and are unrelated to viral infection. Chronic alcohol excess and auto-immune hepatitis are two forms that are not contagious.

Infectious hepatitis is often spread by consuming food or water with fecal contamination due to inadequate hand washing and food preparation.

Hepatitis symptoms are similar for all forms of the disease. Initial symptoms may be so mild they are unrecognized as liver inflammation. When the condition worsens, the following symptoms are common: loss of appetite, exhaustion, abdominal pain, nausea, dark urine, yellow skin/eyes (jaundice).

Hepatitis A (HAV)

HAV is usually a mild, self-limited form of the disease. Infection results from fecal-oral contamination. This means inadequate health practices allow transmission of the virus from feces (stool) into water or food. Once the virus enters the body it takes between 15-50 days for symptoms to occur. If transmitted sexually it is likely through the fecal-oral route and poor health practices. Sometimes international travelers become ill with this via a food or contaminated water outbreak. There is no chronic phase and no specific treatment. The body produces antibodies that persist for life and protect against re-infection. In travelers and high risk people such as those with chronic liver disease and men who have sex with men, vaccination is possible.

Hepatitis B (HBV)

HBV can be self-limited or chronic. After exposure, it takes from 6 weeks to 6 months for symptoms to occur. One-percent of HBV new infections cause liver failure and death. Infected infants have about a 90% chance of chronic hepatitis, this decreases with age. Only 2%-6% of adults who become infected as adults develop chronic liver disease. Chronic HBV increases risk for liver failure and liver cancer – 15%-25%. Risk factors in teens and adults include unprotected sex, history of other STDs and injection-drug use.

HBV is diagnosed with serologic blood testing. Only limited treatment is available. Prevention can be accomplished by immunization, and the use of post-exposure injection of Hepatitis B immune globulin (HBIG) if exposure is known. Infants are now immunized against HBV as are those in risk professions such as physicians, nurses, MSMs, and travelers.

Hepatitis C (HCV)

HCV is a contagious disease spread via blood contact and sometimes by sexual contact. Many people who have HCV infection have no symptoms, but after a short-term illness the infection in the liver becomes chronic. Over years, chronic infection in the liver causes damage and then failure. In years past, this occurred after blood transfusions transmitted the yet unknown virus. Risk practices include unprotected sex, contact with any potential blood source including dental work, acupuncture and tattoos.  Antiviral treatment can be effective.

Zika Virus

Zika virus is a disease spread by mosquitoes, but is also spread by sexual intercourse with infected people. Both infected men and women can spread the virus to a sex partner. Infected pregnant women can transmit the infection to their fetus with dire effects. Infants are often born with severe birth defects and brain damage. Prevention is key. There is no treatment or vaccine at this time.

Human Immunodeficiency Virus (HIV)

HIV is a sexually transmitted disease that begins as an acute viral syndrome caused by a small retrovirus. The disease transitions to a chronic stage, and after months-to-years, ends with Acquired Immunodeficiency Syndrome (AIDS).

The virus infects T-lymphocyte blood cells (CD-4 cells) and destroys them. Depleting CD-4 cells leaves the infected person immune suppressed. Without treatment, the disease is fatal. With early antiretroviral treatment, it becomes a chronic disease and infected people live a near-normal lifespan. Early diagnosis is essential for adequate treatment and to decrease the risk of transmission to others.

The disease can be spread through dirty needles, intravenous drug use, exposure to infected blood and by sexual contact.

Testing: Blood serum screened for an antigen/antibody combination or an antibody immunoassay (IA) is performed. The tests are highly specific and sensitive, capable of detecting HIV-1 and its subtypes. Most can also detect HIV-2. There is a thirty-minute test that gives a preliminary diagnosis, but may be negative in a recently infected person. Supplemental tests must be done. All people who seek STD testing should be screened for HIV.

Treatment: Antiretroviral therapy. Best treated by physicians experienced in HIV/AIDs care.

Pubic Lice (Pediculosis Pubis)

Usually transmitted by sexual contact, but can be transmitted from infected beds or clothing. Itching, nits (eggs attached to hair) and little moving critters will freak you out. OTC topical treatment is available. Shaving hair makes treatment easier. Decontaminating all clothing, bedding, couches, blankets and fumigating the home may be necessary to rid the area of lice. More than one treatment may be needed. If contracted from a sexual partner, consider full STD and HIV evaluation.

Scabies (Sarcoptes scabiei insect infestation)

Scabies causes severe itching and is often acquired via sexual contact in adults. Scabies in children is typically related to sleeping in the same areas or sharing clothing with infected people. The mites must be killed through topical application of OTC medications (ex. Permethrin). All clothing and bedding should be washed in hot water and dried in a dryer. More than one treatment may be necessary. Some medications are toxic to children, so discuss treatments with health department, healthcare giver or pharmacist.

A Short History of Birth Control in the United States

Human Rights March for Equality – Source Library of Congress


Our mother was born in 1916, the same year the first birth control clinic opened in New York. She was a human rights activist and voting advocate until she died at the age of 89.

We received advocacy genes from both of our caring intelligent parents who were self-educated strong individuals raised in poor loving families. They encouraged hard work, independence, and broad horizons. Being females was not a detriment in their eyes but through the years, we have found it a struggle in a man’s world and have personally faced discrimination.

A review of contraception history and factors related to women’s rights is important because so many young men and women today matured during a period when many rights were established. That time has changed. Women gained the right to vote one hundred years ago, a right more important today than ever.

Women, and men who care about them–not to control their bodies and lives but support their independence, have entered a new era of activism.

The Supreme Court actions that overturned Roe v. Wade forces all women into a negative economic and personal rights environment. Contraceptive rights have reverted to the 1800s with religious patriarchs even mandating a child-victim of incest, or victims of rape, carry a resulting conception to term.

Source Samantha-Sophia Unsplash


In 1848, a conference attracted three-hundred women and men who met to gain women the right to vote. It took seventy-two bitter years of activism, hunger strikes, arrests and fighting obstruction for women to prevail. Congress finally passed the Nineteenth Amendment to the U.S. Constitution giving women the right to vote in 1920.

While early activists fought for a woman’s right to vote, another group of feminists spent their lives helping women obtain sex education and access to birth control. One of those women, Margaret Sanger, grew up in a household of poverty with ten siblings. Her mother had eighteen pregnancies.

In 1902, Margaret began working as a nurse, and later a midwife. She cared for chronically pregnant poor women living in the tenements of New York who begged her for information to help stop unwanted pregnancies.

Sanger’s book, Motherhood in Bondage, contains hundreds of letters from hopeless women across the country imploring her to help them limit the number of children they bore. Most of them wrote of being married as teenagers and bearing a child each year. One 43-year-old woman with nineteen children had begged her doctor for contraceptive information, only to be told to be careful. Stories included child-mothers escaping poverty to marry, and having a child before their thirteenth birthday. One, married at age fourteen, had fourteen living children, many miscarriages, and failing health due to multiple pregnancies and poverty.

The women’s plight incited Margaret’s actions, but by talking about birth control she risked imprisonment under the Comstock Act of 1873. That draconian law made it illegal to discuss, produce, print or use the U.S. Postal Service to mail any literature or product pertaining to the body related to birth control and venereal disease, rampant before the age of antibiotics. Anatomy textbooks being sent to medical students were prohibited and confiscated. Doctors failed to educate women about ovulation and contraception because they could be jailed for discussing the topics.

Anthony Comstock, the influential politician and religious zealot who became a U. S. Postal Inspector, considered Sanger’s pamphlets on sex education and clinics providing contraception advice to be obscene and pornographic. His imposed religious views set medical education and U.S. public health back decades.

After her arrest for publishing and distributing contraceptive information, Margaret fled to Europe under an assumed name to avoid prosecution that could have carried up to a 45-year sentence. She studied methods of contraception in the Netherlands and returned to open the first U.S. birth control clinic in New York City in 1916. She and her sister Ethel Byre, also a nurse, provided contraceptive information and treated 486 patients in ten days, before the NYPD Comstock Vice Squad swept in to arrest the nurses and patients.

Ethel nearly died in jail during a hunger strike to raise awareness for their cause. Margaret was sentenced to the penitentiary for thirty days and upon release, reopened her clinic in protest. She founded the American Birth Control League in 1922 that eventually became Planned Parenthood of America.

Margaret Sanger’s desire to help women fueled her lifelong activism to teach contraceptive methods and advance sex education. The Catholic Church considered Margaret an enemy and opposed her work, but she had seen what continual pregnancies had done to her devout mother and others in poverty producing huge families.

Support and fortunes of philanthropic people like International Harvester heir Katherine McCormick, John D. Rockefeller, and Margaret’s second husband, oil magnate James Noah Slee, fueled her campaigns for birth control and research for an oral contraceptive. Sanger and McCormick both lived to see the success of their efforts when the FDA approved the first oral contraceptive, Enovid, in 1960.

In 1972, the Supreme Court finally struck down the last of the oppressive Comstock law that restricted doctors from prescribing oral contraceptives to unmarried women ending nearly one hundred years of Comstock tyranny.

Source Gayati-Malhotra Unsplash


More than sixty years after the epic moment in 1960 making birth control pills available, women are fighting the same old battle, the right to self-determination and contraception.

Some legislators at the national level have vowed to defund Planned Parenthood clinics across the United States. Those who fight to defund the clinics and legislate reduced contraceptive availability and education are antiabortionists. They vehemently attack clinics that provide abortions, leading to violence, bombings, and terrorist murders of healthcare personnel.

Planned Parenthood provides healthcare to both men and women, education, contraceptives, treatment of sexually transmitted diseases, and they offer fertility consultation.

Comprehensive sex education and free contraceptives reduce unplanned pregnancies and abortions. Why would those against abortion defund Planned Parenthood clinics limiting access to education and birth control, thus increasing the need for abortions?

Abortions have been a legal right under U.S. law since the Roe v. Wade Supreme Court decision in 1973. That decision deemed abortion a fundamental right under the U.S. Constitution. Roe, (a pseudonym to protect her privacy) was a single pregnant woman who brought a class action suit against the constitutionality of Texas laws that made abortion a crime except to save the life of the mother. District Attorney Wade provided the state’s defense. The historic decision overturned the Texas law and held that a woman and her doctor could choose abortion in earlier months of pregnancy without legal restriction, and with restrictions in later months based on right to privacy.

Any adult has the right to make personal decisions based on their religious views. However, our founding principle of separation of church and state in the U.S. means no one as the right to impose their religious views on others.

Broad availability of birth control education and contraception has been shown to reduce unplanned pregnancies and reduce the need for abortions. In spite of this fact and the desire of most citizens in the United States, the U.S. Supreme Court overturned Roe v. Wade in this month. Their 2022 sweeping judgement not only removed a woman’s right to make personal healthcare choices, it broadly affects autonomy in every sphere of existence. The partisan justices also tainted the Court and destroyed the established framework of the United States of separation of church and State.

The next blog will provide an overview of Reproductive Biology for men and women, then related topics from the booklet will follow. If you are interested in following the Lipstick Logic blog, please subscribe by providing your email.

Thanks for stopping by.

Betty and Bev, The Lipstick Logic Sisters



Statement of Purpose

Lipstick Logic ™ LLC was founded in 2008 to provide education and health conferences for women. This blog was developed as a way to reach a larger female audience with a wide range of science-based health topics. With woman’s rights having been set back 50 years due to Roe v. Wade being overturned, our focus on women’s issues and health seems even more important.

A new day has dawned for women in America. Freedom of choice can no longer be taken for granted. The Supreme Court ruled against a woman’s right to have an abortion. Although some states will continue to provide education and abortion services, many states are pursuing legal changes to terminate women’s rights, criminalize their actions, imprison practitioners, and even track a woman who might leave her state to obtain needed healthcare elsewhere.

Several years ago, Dr. Betty, a specialist in internal medicine, wrote a primer on contraceptive issues and related biology. Over the next several weeks, this Lipstick Logic blog will provide updated information from that primer.

CONTRACEPTION is a broad topic. Even if you have had a child and have grown up in an age where options for women’s reproductive rights were rights, you may learn new information to share with other women, your daughters, granddaughters, and the men in your life.

ORAL MEDICATION FOR ABORTION will be our first topic. It is a safe option if chosen early in pregnancy. But, if you live in a state that has banned abortions, this medication will not be available to you. Always consult with your private physician regarding your situation and any medical concerns you have.

If you are interested in reading researched, science-based information regarding women’s health and human rights, please join us by subscribing to this blog.

Everyone woman of voting age must vote to protect her rights and freedom.

Betty and Bev, The Lipstick Logic Sisters

Author Note – Betty Kuffel, MD FACP

This science-based publication is a quick reference to understanding the natural processes of reproduction and contraceptive choices available today. Information related to sexual assault and sexually transmitted disease is also included.

My desire is to provide information for informed choices and make this publication widely available to all ages. Reproductive and contraceptive education is known to reduce unplanned pregnancies and the risk of sexually transmitted disease. The need for abortions can also be minimized.

The information is current at the time of publication. Individualized guidance must be obtained from your health practitioner or pharmacist.

Make informed choices. The effects of what you do today will be with you the rest of your life.

If men got pregnant, there would be safe, reliable methods of birth control.

They’d be inexpensive, too.

Anna Quindlen, Pulitzer Prize-winning columnist

 and bestselling novelist



The 1973 Supreme Court decision on Roe v. Wade legalized ending a pregnancy during the first twelve weeks following conception. Prior to the legalization, women were forced to go to untrained abortionists, or aborted themselves using all sorts of objects including knitting needles and rug hooks. Often, they died of hemorrhage and sepsis from infection.

In 2000, the Federal Drug Administration (FDA) approved the first oral medication to induce abortion, (RU-486).  A newer, lower dose drug, Mifeprex (mifepristone), is also available. The FDA lengthened the duration of time it can be used to 70 days (10 weeks) of gestation. The time is calculated from the first day of the woman’s last menstrual period.

  • Mifepristone blocks progesterone cell receptors, a hormone important in maintaining pregnancy. It is used in combination with misoprostol to complete the abortion.
  • Misoprostol softens and dilates the cervix and induces uterine contractions to expel the products of conception. There will be significant cramping and some bleeding when the abortion occurs. A follow-up visit with a practitioner is recommended.

Following the advent of birth control pills, improved education and more options for contraception, pregnancy rates fell, as did the number of abortions. There are still times when women decide to end a pregnancy, however, the current Supreme Court ruling makes it illegal to end any pregnancy even those resulting from violent rape or incest.


* Patient receives counseling, signs an agreement form, and is given a copy of the FDA Mifeprex (GENERIC- mefepristone) Medication Guide.

Note: Cost is markedly reduced from the approximate cost of $100/pill, to $14.00 using WebMDRx.

* A certified healthcare provider dispenses the medications.

* Mifepristone, 200 mg, is taken by mouth.

* 24-48 hours later, misoprostol, 800 mcg, is taken as directed.

This method is 98% effective. If the abortion is incomplete and some tissue is retained, such as remnants of the placenta, a procedure may be necessary to remove the tissue to stop bleeding and infection. See for detailed information.



Emergency Contraception (EC) can be used to reduce pregnancy risk following unprotected intercourse. When taken early and correctly, the medication is usually effective following a rape or unexpected situations such as a broken condom. EC must be used soon after intercourse and will not be effective if pregnancy has already occurred.


If you are raped, Emergency Contraception is recommended to prevent pregnancy. This medication is usually provided in the Emergency Room if the victim seeks medical assistance and a rape exam to collect forensic specimens. Medication to prevent sexually transmitted diseases is also given to victims.

Note: An emergency contraceptive prevents pregnancy. It does not cause an abortion. This treatment will be unavailable in many states under the new Supreme Court ruling that overturned the Roe v. Wade right to privacy and abortion.


The “Morning After Pill” has many forms: Plan B, One-Step, My Way, and others. They are available over the counter, without a prescription. There were no point-of-sale restrictions prior to overturning Roe v. Wade. Many states still allow use of this medication.

Progestin is a hormone that stops or delays ovulation and is best taken within three days of unprotected intercourse. It will not end a pregnancy. Talk with a pharmacist for information and side effects. Cost: ~$40.

Ulipristal (Ella)

This prescription medication delays or prevents ovulation. It can be taken up to 5 days after unprotected intercourse. (It is thought to be more effective than either progestin-only or a combination hormone pill containing both estrogen and progestin.) Cost: ~$40-$60.

Combination pills

These pills contain both estrogen + progestin., taken in two doses and result in delayed ovulation. For dosage, consult with a physician or pharmacist. More information may be found at: Cost ~$30

Copper Intrauterine Device (IUD)

If you are overweight or obese, effectiveness of EC pills is reduced. Insertion of a Copper IUD is effective and provides contraception for ten years. IUDs must be inserted by a health practitioner. More information will be provided later on IUDs. Cost is variable. Placement may be free at Planned Parenthood clinics.  

History of Birth Control in the US

Part Two


Ultraconservative legislators in Texas and other states have defunded Planned Parenthood. More than fifty years after the epic moment in 1960 making birth control pills available, women are fighting the same old battle, the right to self-determination and contraception.

Some legislators at the national level have vowed to defund Planned Parenthood clinics across the United States. Those who fight to defund the clinics and legislate reduced contraceptive availability are antiabortionists. They vehemently attack clinics that provide abortions, leading to violence and terroristic murder of healthcare personnel. Planned Parenthood provides healthcare to both men and women, education, contraceptives, treatment of sexually transmitted diseases, and they offer fertility consultation.

Comprehensive sex education and free contraceptives reduce unplanned pregnancies and abortions. Why would those against abortion defund Planned Parenthood clinics limiting access to education and birth control, thus increasing the need for abortions?

Abortions have been a legal right under U.S. law since the Roe v. Wade Supreme Court decision in 1973. That decision deemed abortion a fundamental right under the U.S. Constitution. Roe, a single pregnant woman brought a class action suit against the constitutionality of the Texas laws that made abortion a crime except to save the life of the mother. District Attorney Wade was the defendant. The historic decision overturned the Texas law and held that a woman and her doctor could choose abortion in earlier months of pregnancy without legal restriction, and with restrictions in later months based on right to privacy.

Any adult has the right to make personal decisions based on their religious views. However, our founding principle of separation of church and state in the U.S. means no one as the right to impose their religious views on others.

Broad availability of birth control education and contraception has been shown to reduce unplanned pregnancies and reduce the need for abortions.

I wrote Modern Birth Control because of the potential loss of healthcare services to men modern-birth-control-kindle-coverand women. The small booklet provides up-to-date information on aspects of health related to contraception, sexually transmitted diseases, treatment, and avoidance of sexual assault. Many references are included. The 44 page book is available on Amazon. Paperback  – E-book –

Betty Kuffel, MD

What Every Sexually Active Woman and Man Should Know


Which Sexually Transmitted Diseases (STDs) are preventable?

Which STDs are treatable but incurable?

Which STDs are treatable and curable?

Which STDs can be fatal?


This science-based publication is a quick up-to-date reference of essential information for sexually active individuals and those with the responsibility to teach others about safe sex practices. An overview of the reproductive biology of males and females provides medical information important to everyone.

Nurse activist Margaret Sanger fought for women’s rights in the early 1900s and risked imprisonment under the Comstock Act of 1873 that prevented doctors and nurses from even discussing contraception with patients. She cared for women who were chronically pregnant. Her mother had 18 pregnancies. Through her work and the work of others, birth control methods are readily available today.

Margaret Sanger founded the American Birth Control League in 1922 that eventually became Planned Parenthood of America.

The first birth control pill became available in 1960. It wasn’t until 1972 that the Supreme Court finally struck down the last part of the oppressive Comstock Act that restricted doctors from prescribing oral contraceptives to unmarried women.

Broad availability of birth control education and contraception has been shown to reduce unplanned pregnancies and reduce the need for abortions. Using condoms markedly reduces the potential for transmitting and acquiring STDs. Some are curable. Some are not and can be fatal. Others leave scarring that may result in sterility.

When is a woman likely to ovulate and become pregnant?

Which forms of birth control are effective?

Are you making informed choices?

Read this little booklet and share the information with friends.

Betty Kuffel, MD