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In celebration of Hispanic Heritage Month, which takes place from September 15 - October 15 every year, Alto is highlighting the important work of Alto Auténtico, our Latinx employee resource group (ERG).

Get to Know Alto Auténtico, our Latinx ERG

In celebration of Hispanic Heritage Month, which takes place from September 15 - October 15 every year, Alto is highlighting the important work of Alto Auténtico, our Latinx employee resource group (ERG)*. Below, Robert Barahona, Provider Success Specialist and co-leader of Alto Auténtico, shares more about the group’s origins, current initiatives, and plans for the future.

Robert: “Auténtico” means authentic in Spanish, and authenticity is central to the ERG’s mission. The group was created to ensure that Alto’s Latinx team members have a presence and a voice within our company culture, and that they are supported in their professional development with meaningful opportunities to grow at Alto.  

Robert: Our focus is both internal and external. In addition to developing a Latinx community at Alto, we also shape Alto’s product and services so that we’re better serving our Latinx users (more about that later). Much of that work involves building awareness of Latinx history and cultural contributions, as well as bringing attention to negative stereotypes that we want to dismantle.

We use holidays and events like Day of the Dead (November 1st and 2nd) and Cesar Chavez’ birthday (March 31) to share educational resources with our team members. On Cinco de Mayo, we hosted a Zoom happy hour and a taco lunch for all our pharmacies.

For last year’s Hispanic Heritage Month, we invited Dr. Robert Rodriguez, the president of diversity consulting firm DRR Advisors and a thought leader in Latinx talent management, to speak at Alto. He shared about his own journey of repressing his background to assimilate in the workplace to fully embracing his heritage and empowering other Latinx employees to be their authentic selves.

How are we celebrating Hispanic Heritage Month this year?

Robert: We’re focusing on celebrating Latinx intersectionality. It’s important to recognize the diversity within Latinx culture and the important perspectives of Latinx women, LGBTQ+ individuals, and those of mixed heritage, including our Black and Asian members who also identify as Hispanic or Latinx. Every week during Hispanic Heritage Month, we’re educating the full Alto team about a specific group within the broader Latinx community, with resources for additional learning.

What can team members look forward to from Alto Auténtico in the future? 

Robert: We’re really excited to continue to help shape Alto’s services and resources for customers, making our offerings as inclusive as possible. We’re currently working with the operations, product, and marketing teams to establish a bilingual team to support Spanish-speaking individuals using our pharmacy delivery services across all of our communities. 

We’re also launching a mentorship program in which Alto’s junior Latinx team members will be paired with senior Latinx team members for coaching sessions. This is another important step in continuing to invest in our Latinx team members’ professional development.

How can allies recognize Hispanic Heritage Month?

Robert: Great question! I think learning is key. Simply taking the time to educate yourself about the Hispanic and/or Latinx experience — particularly about our diversity as a group — goes a long way toward building trust, which is key to true allyship.

Interested in learning more about the Alto Auténtico employee resource group? Reach out to altoautentico@alto.com and visit alto.com/careers to learn more about our open roles. 

*ERGs are meant to empower community groups within an organization by directly linking decision makers and implementing policies that support the group’s specific needs. The groups often center around a shared identity or experience and focus on building community, providing support, and contributing to its members’ personal and professional well-being. By creating an open forum for employees to come together, discuss challenges and opportunities, and foster a sense of belonging, ERGs help both individuals and organizations thrive.

In celebration of Hispanic Heritage Month, which takes place from September 15 - October 15 every year, Alto is highlighting the important work of Alto Auténtico, our Latinx employee resource group (ERG)

PEP is a medication you can take within 72 hours of potential exposure to HIV to lower your chances of contracting the virus. Read on to learn more about who is eligible for it and when to use it.

What to Know About Using PEP to Prevent HIV Infection

PEP, or post exposure prophylaxis, is a medication you can take within 72 hours of potential exposure to HIV to lower your chances of contracting the virus. While some research indicates that this groundbreaking medication may be able to lower your risk of HIV infection by up to 80%, it is only effective when taken as prescribed and is not intended to be a method of ongoing, recurring HIV prevention (see our article on PrEP to learn more about long-term preventative options).

Read on to learn more about what PEP is (and what it isn’t), who is eligible for it, and when to use it.

PEP is a medication regimen that you begin taking as soon as possible after potential exposure to HIV and continue with for at least 28 days. It typically consists of three medications: Truvada® (emtricitabine/tenofovir) with either Tivicay® (dolutegravir) or Isentress® (raltegravir). Your healthcare provider will recommend the best medication regimen for your health needs during your consultation.

These medications are antiretrovirals, a type of medication that blocks various stages of a virus’ life cycle. In this case, PEP prevents HIV from spreading throughout your body. Taking PEP medications as prescribed throughout the entire 28-day duration is critical to its effectiveness.

It’s important to reach out to a healthcare provider or pharmacist to start PEP as soon as possible if you believe you were exposed to HIV. The virus spreads very quickly — typically within 24 to 36 hours of exposure — and it is recommended to begin taking PEP within 72 hours, or three days, of potential exposure. 

And the sooner you begin your PEP regimen within that 72-hour window, the more effective the medication is at blocking the virus. If your potential exposure to HIV falls outside of that 72-hour window, you should still seek medical attention as soon as possible for further evaluation.

PEP may cause some side effects such as nausea, vomiting, diarrhea, and fatigue, however these are mild in most cases. Be sure to inform your healthcare provider of any other medications you currently take, as these may interact with PEP.

If you experience a rash or fever while taking PEP, you should contact your doctor as soon as possible, as these may indicate the early stages of HIV.

PEP works most effectively for people who may have been exposed to HIV within the last three days. That primarily includes anyone who had unprotected sex with or who shared needles or other drug paraphernalia with someone who may have HIV. It is also recommended in instances of sexual assault or if you used a condom that broke while having sex with someone who may have HIV.

PEP baseline testing and ongoing monitoring

Recommended baseline screening for PEP includes a rapid HIV test, kidney and liver function tests, a pregnancy test for women of reproductive age who aren’t using birth control, and screening for sexually transmitted infections (STIs). However, if baseline screening isn’t available when you reach out to a healthcare provider or pharmacist to start PEP, they will likely advise you to take your first dose before you complete the tests, in the interest of starting PEP as soon as possible. Additional HIV testing is recommended at 30 days and 90 days after the potential exposure to confirm your HIV status.

In all states, any licensed doctor or nurse can prescribe PEP. And in a growing number of states, including California, Colorado, and Nevada, pharmacists are also allowed to prescribe PEP. 

Since the medication should be taken as soon as possible after exposure, PEP is commonly prescribed by emergency room doctors. It is also available at many sexual health clinics and community-based health centers, but if you have been exposed to HIV after standard working hours, you should visit your nearest hospital’s emergency department as soon as possible.

PEP isn’t an ongoing method of HIV prevention

PEP is only for emergencies and infrequent exposures, as it is not 100% effective in preventing HIV even when taken as prescribed. It should not be considered a substitute for proven methods of long-term HIV prevention, including condoms and/or taking PrEP, a medication that can lower your risk of sexual transmission of HIV by 99% when taken daily. It is also important to continue using condoms during your 28-day course of PEP.

If you have had several potential exposures to HIV, speak with your doctor about potentially taking PrEP to prevent HIV infection in the long term.

Alto can help you navigate PEP or PrEP access

Alto pharmacists will work with your insurance (if applicable) and any third party savings programs so that you can get PEP at the lowest possible price. 

There are several patient assistance programs designed to reduce the cost of PEP for individuals without insurance, including Gilead’s Advancing Access Program and ViivConnect. If you’re eligible, we’ll automatically enroll you in these programs as soon as we receive your prescription.

We can also help you get started with PrEP if you and your doctor decide that it’s right for you. In addition to support with navigating insurance and patient assistance programs, you can expect:

Discrete, private packaging and free, same-day delivery

Med syncing support to eliminate extra deliveries each month and in-app reminders to stay on track

Pharmacists directly available through phone or within the Alto app seven days a week

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Editor’s Note: This post was originally published in September 2021 and has been updated for accuracy and completeness.

September is Pulmonary Fibrosis Awareness Month, an annual month of education and action to bring attention to chronic lung disease.

Pulmonary Fibrosis Awareness Month: Understanding the Lung Disease

September is Pulmonary Fibrosis Awareness Month, an annual month of education and action to bring attention to chronic lung disease. A 2020 survey conducted by the Pulmonary Fibrosis Foundation found that 86% of Americans did not know the symptoms of pulmonary fibrosis, which affects more than 130,000 people in the United States. 

This lack of awareness may stem from the fact that pulmonary fibrosis presents with symptoms similar to more common respiratory conditions like COPD, as well as the fact that pulmonary fibrosis is a group of many lung diseases.

Greater education around this progressive lung disease is critical: the more you know how to recognize the signs of pulmonary fibrosis, the more likely you are to receive a diagnosis at an earlier stage, should you be affected. Better understanding of pulmonary fibrosis starts by simply knowing the facts, so, take a few minutes to learn more.

There are more than 200 types of pulmonary fibrosis. In each type, the lungs become scarred, making it difficult to breathe. Unlike COPD and some other lung diseases, pulmonary fibrosis falls under the umbrella of interstitial lung disease. Pulmonary fibrosis damages interstitial lung tissues, which are the cells that fill the space between blood vessels and other structures inside the lungs like the trachea and bronchial tubes.

Another way that pulmonary fibrosis differs from COPD is that it has a wider range of causes beyond cigarette smoking alone. Long-term exposure to pollutants and toxins, certain medical conditions and medications, and radiation therapy can also play a role in causing pulmonary fibrosis.

The most common type of pulmonary fibrosis is idiopathic pulmonary fibrosis (IPF), which literally means pulmonary fibrosis of an unknown cause. While doctors are unable to isolate a single cause of the condition in these cases, the following risk factors may increase your chance of developing IPF:

A diagnosis of a condition that often co-occurs with pulmonary fibrosis (also referred to as a comorbidity) such as acid reflux, sleep apnea, or pulmonary hypertension

While researchers continue to work toward a cure, a combination of medications, oxygen therapy, and active lifestyle choices can slow the progression of pulmonary fibrosis. Getting diagnosed at an early stage is key to a better prognosis.

These are the most common symptoms of pulmonary fibrosis:

Since many of these symptoms overlap with those of COPD and other lung diseases, additional tests, including blood and imaging tests and pulmonary function tests, are often needed to confirm a pulmonary fibrosis diagnosis. Your doctor may also take into account the presence of the known risk factors mentioned above when determining if you have pulmonary fibrosis, including any related health conditions.

A long-term lung disease like pulmonary fibrosis may affect you both physically and emotionally, and it’s important to surround yourself with support. In addition to having a strong care team, there are many opportunities to connect with other individuals living with the condition, who understand your experience better than anyone.

The Pulmonary Fibrosis Foundation offers both virtual and in-person support groups. The PFF also has a phone group for all members of the pulmonary fibrosis community called PFF Voices, where you can discuss any pulmonary fibrosis-related topic or concern. The group meets on the third Thursday of every month.

The American Lung Association’s Better Breathers Club has a variety of resources for individuals living with lung diseases, including virtual meetings. The ALA also supports free online communities on Inspire.com that offer peer-to-peer support for people living with lung diseases, and there is a group specifically focused on living with pulmonary fibrosis. You need to create an Inspire.com account to access the group.

If you are caring for someone with pulmonary fibrosis, there are also resources to help you navigate your loved one’s treatment needs.

Read the Pulmonary Fibrosis Foundation’s suggestions for caregivers.

The PFF also offers a phone group created specifically for caregivers called PFF Caring Conversations, where you can share your experiences as a caregiver. The group meets on the first Tuesday of every month.

The American Lung Association supports an Inspire.com group for pulmonary fibrosis caregivers called Caring for Pulmonary Fibrosis. You need to create an Inspire.com account to access the group.

Alto is here for you, too. We want to make it as easy as possible to follow the treatment your doctor has recommended, so we offer free hand-delivery of your medication, automatic savings investigations, and easy medication management tools through our website and app. And our team of pharmacists is always here to answer your questions.

Reach out any time by phone at 1-800-874-5881 or in-app messaging.

Heart-healthy living is a lifelong practice. To help you get started, we’ve compiled a list of the top heart disease prevention actions to tackle during each decade of life.

How to Prevent Heart Disease at Any Age

You may associate heart disease with aging, and for good reason — individuals age 65 and older face a higher risk for the condition. This stems in part from how aging-related changes in your body overlap with risk factors for heart disease. For example, your arteries and heart muscle stiffen with age, making it more difficult to pump blood well during exercise.

Still, it’s never too early to prioritize a heart-healthy lifestyle. As heart disease-linked conditions like diabetes and high blood pressure grow increasingly common among young adults, many people are now becoming at risk for heart disease at an earlier age. 

And even if you are young and in good overall health, the choices you make today can affect your heart health for years to come. Cardiovascular health issues like heart attacks, strokes, and heart failure often stem from a lifetime’s worth of health choices, including many you have control over.

Since heart-healthy living is a lifelong practice, it may feel more manageable if you set specific goals and priorities impactful for your age group. To help you get started, we’ve compiled a list of the top heart disease prevention actions to tackle during each decade of life. This is intended to be a high-level guide to prevention, so consult with your healthcare provider about more targeted priorities based on your individual health needs.

2. Search for a primary care provider if you don’t have one

3. Find your favorite physical activity and develop a fitness routine

You’re out in the real world, exploring what you want your life to look like. It’s normal to experience some anxiety during this exciting but nerve-racking time. Your cardiovascular health may not be top of mind as you navigate a stressful job search, adjust to the pressure of beginning a career, or start a family, but taking several heart healthy actions during this decade of life will put you on the right track early on.

Focus on building a foundation for a healthy lifestyle. That means quitting smoking if you currently smoke, figuring out which physical activities work for you, and getting in the practice of staying up to date with yearly doctor’s appointments. If you don’t already have a primary care provider, now’s the time to search for one.

1. Create a weekly routine that makes time for exercise

2. Prioritize your mental health — whatever that looks like for you

3. Contact relatives to build your family medical tree

There’s a good chance your calendar’s looking pretty packed these days. Momentum in your career may come with more responsibilities and later nights in the virtual or physical office. And for those who already have a family, or are thinking of starting one, maintaining work-life balance may be a challenge.

As you continue to build on the foundation you set in your twenties, here are three new action items to add to your health routine. First, remember your favorite physical activity? Make sure there’s a block of time in your schedule for it each week.

Since your mental health can significantly impact your physical health — and your risk for heart disease in particular — be sure to give your emotional well-being some attention during what may be a hectic time. 

Some stress is to be expected when you have many responsibilities at work or home (or both), but if you’re concerned about your mental health, don’t be afraid to ask your doctor for suggestions or resources. You can also check out Moodfit, a free mood-tracking app, or Insight Timer, an app that offers free guided meditations.

Lastly, since your family’s health history is a big predictor of your own risk for cardiovascular disease, take some time to contact relatives and figure out if heart health issues run in your family tree.  

1. Continue to explore your exercise options

3. Stay current with annual check-ups and screenings

Does it feel like life has only gotten faster? Believe it or not, your metabolism has already begun to slow down. That means it’s time to amp up your workout routine, if you haven’t already. Enjoying your chosen exercise method is key to sticking with it in the long term, so if you haven’t found your go-to activity just yet, keep looking. If you’ve only ever worked out on your own, try a group class, online or in person.

It’s time to check in on your sleep hygiene, too. Regular sleepless nights have been linked to heart attacks, high blood pressure, and diabetes, so if you’re getting in less than an average of seven hours every night, try to set yourself up for a good night’s sleep. Winding down at the same time each night, avoiding heavy meals just before bed, and spending plenty of time outside are just a few of the simple steps that might be able to help you get more rest.

At your annual physicals, be sure to discuss your risk for heart disease with your doctor and ask about recommended screenings for your individual health needs, including a fasting blood glucose test to screen for diabetes.

2. Limit your sodium and cholesterol intake

3. Learn the warning signs of a heart attack

Your risk for high blood pressure and high cholesterol will continue to increase as you age, so it’s important to keep track of your blood pressure, cholesterol, and blood glucose levels. If you have high blood pressure or cholesterol, follow the treatment plan your doctor has recommended, which may include diet changes, medication, or a combination of both. Even if your blood pressure and cholesterol numbers are within a healthy range, you can only benefit from limiting your sodium and cholesterol intake.

You should also learn the warning signs of a heart attack, as your risk for one also increases with age: 65 is the average age of a first heart attack for a man, and 72 is the average age of a first heart attack for a woman.

Keep in mind that heart attack symptoms may appear differently in women than in men.

Remember, these suggestions are intended as a starting point. Your doctor can advise you on a more individualized plan of action based on your health history. And not only is it never too early to begin prioritizing heart disease prevention, but it’s also never too late. Don’t worry about what you should or could have done earlier in life — instead focus on the actions you can take to be as healthy as possible in the present.

Staying physically active and avoiding foods that are high in sodium and trans fats are simple ways to take charge of your health at any stage of life. Here are more specific suggestions for heart-healthy living in terms of diet and exercise.

As you plan a heart-healthy diet, opt for foods that are low in saturated fats and trans fats, which increase levels of low-density lipoproteins (LDL) cholesterol — also referred to as “bad cholesterol” — in your blood. Low-fat dairy products and chicken are healthier alternatives to full-fat dairy products and red meats, which are high in saturated fats.

High sodium intake can increase your blood pressure, and the American Heart Association suggests aiming for 1,500 mg of sodium/day. Limit processed or prepackaged foods including soups, cold cuts, bread, and frozen meals since they contain sodium-based preservatives. And watch out for compounds that contain sodium as you scan the ingredient list, like sodium benzoate and sodium tripolyphosphate.

Regular exercise can help you maintain a healthy weight and keep your blood pressure, cholesterol, and blood sugar levels in a healthy range. Different activities offer various levels of intensity, and there are a variety of ways to get the American Heart Association’s recommended amount of aerobic activity . You should aim for about 150 minutes a week of moderate-intensity aerobic activity, like brisk walking, or 75 minutes a week of a more intense activity. Many people start off slower and build their way up to a more intense routine.

At Alto, we’re committed to making it as simple as possible to protect your heart health and stay on top of cholesterol-lowering or blood pressure management medications. We offer free same-day delivery and medication management tools like reminders and auto refills in our app. And our team of pharmacists is always here to answer your questions by phone or chat, and will even remind you when your medications are due for a refill.

How to Prevent Heart Disease at Any Age 

Our pharamcists explain more about the various types of allergies, how an allergist or immunologist can help, and when it may be time to see one.

When to See a Healthcare Specialist for Allergy Treatment

There’s a wide spectrum of allergy conditions, from mild seasonal allergies to more severe symptoms that persist year round. It makes sense, then, that there is also a spectrum of allergy treatment options.

Some people are able to manage mild symptoms with occasional use of over-the-counter allergy medications, including oral antihistamines like Claritin®, Allegra®, and Zyrtec®; decongestants like Afrin® and Sudafed®; and nasal corticosteroids like Flonase® and Nasacort®. But if allergies impact your focus at work or school, or prevent you from living a more active life, you may consider consulting with a healthcare professional about treatment options.

In addition to your primary care provider, there are specialists with extensive training in allergy treatment such as allergists and immunologists. They can help you better understand the cause of your symptoms so that you can determine a more effective allergy treatment plan. Below, we explain more about the various types of allergies, how an allergist or immunologist can help, and when it may be time to see one.

There are many types of allergies, but all are produced by a reaction in your immune system. In people with allergies, the immune system interprets substances like dust, pollen, and pet dander as harmful. The immune system then kicks into defense mode, producing antibodies to attack the allergen, which in turn causes symptoms such as wheezing, sneezing, and itching in the eyes, nose, ears, or mouth.

There is often a hereditary component to allergies, so you may be more likely to develop allergies if you have a family history of the condition. While many allergies begin during childhood, they may also occur for the first time in adulthood. Some childhood allergies improve with time, but they can also reappear later in life after years without symptoms.

Here are some of the most common allergy conditions. 

Allergic rhinitis is a broad term for any sinus-related allergic reaction. Symptoms generally include watery eyes; itchy eyes, nose, ears, and mouth; runny or stuffy nose; sneezing; puffy eyes; and post-nasal drip. This reaction can be triggered by a range of allergens and may occur year round or seasonally.

Pollen and outdoor mold typically trigger seasonal allergic rhinitis — sometimes referred to as hay fever — while dust mites, pet dander, and indoor molds can trigger these symptoms at any time of year in certain individuals.

Asthma is a lung condition in which the airways narrow and become inflamed, making it difficult to breathe. Coughing, wheezing, and shortness of breath are some of the most common symptoms. As with allergies, there’s a wide spectrum of severity. For some individuals, asthma symptoms are an occasional annoyance, but for others they can be life-threatening.

Allergy-triggered asthma, which is relatively common in children, occurs when allergens affect the lungs and lead to asthma symptoms. Allergy-triggered asthma can result from allergens linked to both seasonal and year round allergies.

If you or your child suffer from allergy-induced asthma, allergy medications will likely be a part of your asthma treatment plan, but they are not a substitute for asthma medication. In addition to consulting an allergist, speak with your primary care provider as soon as asthma symptoms appear so that you can find the best treatment plan.

Many common skin conditions, including eczema and hives, are an allergic reaction caused by various triggers, including pet dander and certain types of medication or food. Part of an allergist’s role is to help you determine if a skin condition is allergy-related. A dermatologist can also help you understand the underlying cause of your skin condition and recommend treatment options.

For some individuals with severe allergies, exposure to an allergen can become life-threatening. This is called anaphylaxis, an extreme allergic reaction to food, medication, or venom. Bee stings or foods like peanuts and tree nuts are among the most common triggers of anaphylaxis.

If you have been diagnosed with anaphylaxis, your healthcare provider will likely prescribe epinephrine to use in the event of an emergency. This medication prevents anaphylactic shock from becoming life-threatening.

When should I see an allergist or immunologist?

Allergy and immunology is an area of medicine focused on the treatment of conditions related to the immune system, including allergies. Allergists and immunologists are specialists in diagnosing allergy conditions and asthma. (In the United States, the two roles are essentially interchangeable.) They can help identify the specific triggers of your allergy symptoms and prescribe the most effective medication for your allergies. To be certified by the American Board of Allergy and Immunology, these specialists must complete two or three years of study in allergy and immunology in addition to a three-year residency after earning their medical degree.

If your allergy symptoms persist after trying over-the-counter medications and consulting with your primary care provider, it may be time to see an allergist or immunologist for more lasting relief. And if you have used over-the-counter medications for longer than several weeks to treat allergy symptoms, you may also benefit from consulting a specialist, as these medications aren’t meant for long-term use and become less effective with time

Understanding the source of your allergy symptoms is key to effective treatment, and allergists and immunologists are able to help you identify your trigger(s). They may recommend a skin test in which they will lightly prick or scratch your finger with a small amount of a suspected allergen, like pollen. Then, they can watch how your body absorbs that substance to determine if you have an allergic reaction. They may also use a blood test to determine what’s triggering your allergies.

Avoiding allergens as much as possible plays a big role in controlling symptoms. However, if you are unable to avoid the substance that triggers your allergies, a specialist can recommend treatment options, including prescription medications and immunotherapy.

It may be possible to train your body to become less allergic to a specific trigger through a process known as immunotherapy. In this preventative treatment, a doctor will gradually give you larger doses of the substance that triggers your allergies. As you become exposed to larger amounts of the allergen, your immune system will become less sensitive to it. Ideally, this will help you experience fewer allergy symptoms when you encounter the allergen in the future.

There are several types of immunotherapy, including allergy shots and sublingual tablets, which are placed under the tongue. This treatment approach is most effective if a doctor has isolated one or more specific allergens as the source of your symptoms, which is why testing is so important.

Choose a reliable and flexible pharmacy partner

Alto makes it as simple as possible to follow the treatment your doctor recommends. Our team of patient care pharmacists will work with your doctor to get you the allergy or asthma medications you're prescribed at the best price, and we’re happy to answer your questions about medication side effects or any other health concern. Reach out any time through phone at 1-800-874-5881 or in-app messaging.

Reproductive endocrinologist Dr. Guy Ringler — a former faculty member at UCLA and an advisory board member at Men Having Babies — was one of the first doctors in the world to help gay men have children through assisted reprodutive technology.

Spotlight on Men Having Babies & Dr. Guy Ringler

There are many ways to start a family and raise a child. And as recent decades have brought forth milestones in marriage equality and the fight for LGBTQ+ rights, the options for LGBTQ+ family building have also expanded.

According to 2019 data from the Williams Institute, almost 29% of people who identify as members of the LGBTQ+ community are raising children, up from 16.2% between 2014 - 2016. That includes a growing number of gay men who’ve had children through surrogacy, a process in which a woman who is not related to the child — a gestational surrogate — carries a baby who is biologically related to one of the fathers and an egg donor.

Breaking down barriers to LGBTQ+ family building

Reproductive endocrinologist Dr. Guy Ringler — a former faculty member at UCLA and an advisory board member at Men Having Babies — was one of the first doctors in the world to help gay men have children through assisted reprodutive technology. Throughout the twenty-five years that he’s been in practice, he’s seen how scientific advances and cultural changes have broken down barriers for gay men interested in parenthood.

“Over two decades ago, when I began my career, people barely understood the concept of surrogacy for gay men,” he says. “It wasn’t as easy to find women who wanted to become surrogates for gay couples. There was still fear about HIV, and there were questions about the impact of surrogacy on a child’s development.”

The landscape looks a lot different today. Thanks to cultural shifts and greater understanding of the science behind surrogacy — and to awareness-raising organizations like Men Having Babies — there are now more options than ever to become a parent regardless of your sexual orientation or gender identity.

“Greater acceptance of the LGBTQ+ community and marriage equality has opened people’s minds and allowed them to see that gay families can thrive, just like any family,” Dr. Ringler says. “Gay men are now able to plan for a future that we once didn’t know was possible.”

Getting to meet prospective fathers at Men Having Babies’ annual conferences is one of Dr. Ringler’s favorite things about working with the organization. He’s observed a greater number of gay men pursuing parenthood at an earlier age.

“I’m so inspired by the next generation of gay men, who are planning their families in their twenties. That simply wasn’t an option when I was their age.”

Men Having Babies and financial assistance for IVF and surrogacy

There are many steps on the road to parenthood for LGBTQ+ individuals and couples: fertility treatments, legal consultation, and financial planning are all required to start a family.

“Having a baby doesn’t just happen for gay men,” Dr. Ringler says. “It takes thoughtful planning and there are many decisions along the way.”

That’s why support from organizations like Men Having Babies is so critical. The organization started as a program at The Center (formerly the NYC LGBT Center) in 2005 and officially became a nonprofit in 2012. Today, Men Having Babies supports thousands of gay men and couples around the world in starting their families through surrogacy, with monthly workshops, annual conferences and financial resources. 

Determining how to pay for IVF and surrogacy is an important part of planning your family. As part of the process, Dr. Ringler suggests mapping out a vision for your family. Knowing how many children you want can help you prepare for the cost: “When you’re making the commitment to start a family as a gay man, think about how you will financially support the decision. It may feel overwhelming, but it’s similar to the process of buying a house. If it’s really important to you, you can find a way to make it work.”

There are many resources to help alleviate the cost, including Men Having Babies’ Gay Parenting Assistance Program (GPAP) . The program offers different forms of financial support, including:

Discounted and free services donated by more than one hundred leading IVF, surrogacy, egg donation, and legal service providers to prospective parents (Stage I support)

Discounted and donated ancillary services, including fertility medication, escrow services, and insurance resource services (Stage I support)

Cash grants for approved prospective parents based on income eligibility (Stage II support)

Learn more about the criteria for applying to Stage I or Stage II support from the GPAP.

You must be a member of Men Having Babies to receive financial assistance. You can become a member by making an annual donation of $150 or more. Learn more about the membership process.

In addition, EMD Serono offers financial assistance for fertility medications and Family Equality has a list of family-building grants that help LGBTQ+ families afford fertility treatment. Be sure to also ask your fertility clinic or pharmacy about available financial assistance programs and payment plans.

The importance of researching your options

As Dr. Ringler emphasized, gay men building a family through IVF and surrogacy have many decisions to make throughout the process. For that reason, it’s important to thoroughly research your options and to work with a medical team that you trust. Here are some additional considerations to be mindful of as you plan your family.

Understanding the process of IVF and surrogacy

In IVF, eggs and sperm are combined in a laboratory. When gay men conceive through IVF, the sperm will come from one of the fathers and the eggs will come from a donor. Then the fertilized eggs, or embryos, are placed into the uterus of a gestational carrier who will carry the baby to term.

Not only is this an exciting time for expectant dads, as Dr. Ringler notes, but surrogates can play a big role in raising awareness of LGBTQ+ families.

“In my experience, surrogates who are asked when their baby is due while out in public may feel comfortable sharing that they’re having a baby for a gay couple. This helps open up more people’s minds to the possibilities for LGBTQ+ parenthood.”

Understanding your goals for your relationship with your surrogate is one of many key decisions, and there is a spectrum of options. Some couples cultivate intimate relationships with the surrogates while others prefer to remain more detached. There’s no one right choice — it’s all about understanding what’s best for you.

“If your surrogate wants a little distance, that does not mean that they are any less committed to the process,” Dr. Ringler says, adding that it’s important to discuss your preferences in an open discussion with your surrogacy agency.

Deciding who will be biologically related to the child

Another important decision for same-sex male couples is deciding which parent will be genetically related to the child. When heterosexual couples have babies through IVF, both parents can contribute their genetic material, so that the baby is biologically related to both, even when using a gestational carrier. 

But with gay men, only one father can contribute his sperm per pregnancy, so it’s important to discuss this decision with your partner if having a child as a couple. Some fathers fertilize multiple eggs so that both can have a biological connection with one of their children. Taking time to identify your family building goals will allow you and your partner to plan for the financial cost of more than one round of IVF, if you choose to pursue that option.

Keep in mind that you can establish a legal paternal relationship with your child even if you are not biologically related to them. It’s critical to research your state’s laws about legal parentage procedures once your baby is born. Movement Advancement Project’s interactive map on parental recognition laws is a good starting point. 

Be sure to speak with an experienced LGBTQ+ family lawyer in your state before starting the IVF and surrogacy process. There are many forms of financial support to help alleviate the cost of these legal services, like Men Having Babies’ Gay Parenting Assistance Program.

There's a wide selection of available egg donors, and one of the factors to consider as you choose yours is whether they will be anonymous or open. With an open donor, you can more easily answer any questions your child may have about their genetic background. However, some families prefer anonymous donors, and sometimes an anonymous donor’s physical or personality traits better fit your goals. Both paths are viable options, and it all comes down to what’s right for your family.

Regardless of which option you choose, Dr. Ringler notes that you should be prepared to share information with your child about how they were conceived. You can even get creative with how you share their journey: some of Dr. Ringler’s patients have created story books for the whole family to read together, which helps children understand their background and feel proud of who they are.

Seeking support for your family building journey

While there are many paths to take, and many decisions to make, as you build your family, all will lead to the same destination of parenthood.

“I personally had a very close relationship with my mother growing up, and as gay men, we can’t guarantee our children that same experience,” Dr. Ringler says. He notes that if you have an open donor, your child’s biological mother may be able to have a presence in their life, which is another important factor to consider when planning your family.

But regardless of your chosen family structure, “I’ve seen again and again throughout my career that all you need to start a happy, healthy family is love and fun.”

One thing that’s certain: family building as a gay man is much easier to navigate with support from organizations like Men Having Babies. If you’re feeling overwhelmed while planning for a family, remember that you don’t have to go through this journey alone. Men Having Babies understands the challenges specific to building a family as a gay man, and their resources can help you fulfill your dreams of becoming a parent.

Learn how to become a member of Men Having Babies.

At Alto, we’re proud to support Men Having Babies, and we’re happy to be a part of your family building journey if fertility prescription medications become part of your plan. Reach out any time to get started though the Alto app  or phone at 1-800-874-5881.

In recent years, dry powder inhalers have become increasingly common in asthma treatment thanks to their ease of use and portable size. Read on to learn how to use a dry powder inhaler correctly.

What to Know About Dry Powder Inhalers

Medications play a critical role in managing asthma by reducing the frequency and severity of symptoms and allowing for a more active life. There are a variety of asthma medications that your healthcare provider may prescribe for you, including quick-relief medications to treat acute symptoms and long-term control medications to prevent flare-ups.

Most asthma medications are taken via an inhaler. There are three types of inhalers used for asthma treatment: hydrofluoroalkane (HFA) inhalers, sometimes referred to as metered dose inhalers, dry powder inhalers (DPIs), and the less commonly used respimat inhalers.

In recent years, dry powder inhalers have become increasingly common in asthma treatment thanks to their ease of use and portable size, which makes them convenient to use if symptoms flare up unexpectedly. As with any device, proper use of your DPI is essential to receiving the full benefits of your medication, and it’s important to be mindful of several differences between DPIs and other inhalers. Read on to learn how to use a dry powder inhaler correctly.

A dry powder inhaler is a handheld device that allows you to inhale your asthma medication in the form of a dry powder. It is a breath-activated device, so it will activate and release your medication automatically as soon as you start inhaling. Unlike HFA inhalers, which use a chemical propellant to deliver a dose of your medication in aerosol form, DPIs do not contain any ingredient other than the medication itself.

Your doctor may prescribe a DPI because of  dosage reliability. With an HFA inhaler, it may be difficult to know that you’ve received the entire metered dose. In contrast, most DPIs are specifically designed with a spinning technology that ensures you receive the full dose of your medication. DPIs also typically give you a visual indication that the full dose has been delivered. For example, the Advair Diskus® has a built-in dose counter which updates after each use.

If your doctor prescribes your medication to be administered with a DPI, your prescription will include both the DPI device and the medication. Commonly prescribed DPI medications include the Advair Diskus®, the Pulmicort Flexhaler®, and the Asmanex Twisthaler®.

How to use a dry powder inhaler correctly

Here is a step-by-step breakdown of how to use a dry powder inhaler correctly.

Remove the cap from your dry powder inhaler if there is one.

Load a dose of medicine, if needed. Some DPIs have a supply of medicine in them already while others require you to load each dose of medication. Follow your healthcare provider’s guidance.

Tilt your head back and breathe out to empty your lungs as much as possible. Make sure to hold your inhaler away from your mouth while you exhale, as breathing into your inhaler can blow out some of the medicine.

Place the mouthpiece of your inhaler in your mouth. Close your lips tightly around the opening so that the medicine cannot get out.

Inhale quickly and deeply for 2-3 seconds. Since DPIs are breath-activated, it’s important to breathe deep and fast so that the right dose of medicine is triggered.

Once you have inhaled the powder, remove the inhaler from your mouth and hold your breath to let the medication settle into your lungs. Then exhale slowly.

If your doctor has prescribed more than one dose of your medication, wait about a minute before taking your next dose.

If you are using an inhaled corticosteroid, gargle and rinse your mouth afterward with water to prevent throat irritation and oral yeast infections, two potential side effects of this medication class.

You may not necessarily taste or feel the dry powder after taking your medication, but as long as you’ve followed the steps above, you will receive the full dose.

It’s normal to have questions when starting a new medication, and our team of pharmacists is here to offer guidance. We can walk you through the steps of using your inhaler, discuss potential side effects, and answer any other questions you may have. In addition, we offer free, same-day delivery and medication management tools like reminders and auto refills in our app to make it as simple as possible to stay on track with managing your asthma.

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