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The HIV prevention medication PrEP — short for pre-exposure prophylaxis — has played a critical role in reducing the number of new HIV infections in recent years. It is highly effective when taken as prescribed every day, lowering the risk of sexual transmission and intravenous drug transmission by 99% and 74%, respectively.

What to Know About PrEP Follow-Up Appointments and Testing

Staying on track with PrEP treatment includes not only taking the medication as prescribed, but also regularly attending all follow-up appointments and completing recommended lab tests. Here’s an overview of ongoing medical care related to PrEP.

Note that PrEP is distinct from PEP — post-exposure prophylaxis — a prevention medication for emergencies and accidental exposures. Learn more about PEP.

If you think PrEP may be right for you, make an appointment with your doctor or other healthcare provider as a first step. (Check with your provider about the possibility of telehealth appointments, if interested.) They can write you a prescription for PrEP and conduct an HIV test, which is required to begin taking the medication.

If you do not have a provider or are unable to get a prescription from your doctor, the following resources can connect you with a provider who will prescribe PrEP for you:

There are several FDA-approved oral medication options — Truvada®, Descovy®,  and a generic for Truvada — and as of December 2021, PrEP is now available as an injectable treatment option called cabotegravir (Apretude®).

For those who find it difficult to remember to take a pill every day, the injectable form may make it easier to stay on track with PrEP treatment. However, oral PrEP continues to offer highly effective prevention for anyone at risk of HIV infection.

Always consult with a doctor if you are interested in switching from one form of PrEP to another.

What is the typical schedule of medical appointments when taking PrEP?

Work with your provider to determine the frequency of your follow-up appointments. A typical schedule often consists of the following:

First follow-up appointment between 2-4 weeks

Ongoing follow-up appointments every three months

What happens at the initial intake appointment?

If you are interested in getting started with PrEP, the first appointment will include an overview of PrEP as well as HIV testing and other lab work. If you qualify for PrEP and can commit to start taking the medication as prescribed, your doctor can write a prescription right away.

The baseline lab work includes the following:

An HIV test, to confirm that you do not have HIV at the beginning of your PrEP treatment

Testing to screen for other sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis

A blood test to measure kidney function (for those prescribed oral PrEP medications)

A blood test to measure cholesterol and triglyceride levels (for those prescribed oral PrEP medications)

What happens at the first follow-up appointment?

Your provider will have you come in for a follow-up appointment between 2-4 weeks. This appointment is an opportunity to discuss your experience with the medication so far, including side effects. It’s also a good time to share any other concerns, such as financial difficulties or medication adherence. Your provider will likely be able to refer you to resources.

What happens at ongoing follow-up appointments?

If you are taking oral PrEP, you will have follow-up appointments every three months. At these appointments, your doctor will:

Conduct an HIV test and assess you for symptoms of acute HIV infection to confirm that you still do not have HIV.

Provide a prescription or refill authorization of daily oral PrEP medication for no more than 90 days.

Discuss any challenges with medication adherence and answer any questions you may have.

Conduct screening for other STIs including syphilis, gonorrhea, or chlamydia.

At the six-month mark, your doctor will likely measure kidney function. (Kidney testing may be more frequent depending on individual health factors.)

They may also ask about your interest in continuing with or stopping the medication. It is important to always consult with a provider before discontinuing or restarting PrEP so that they can evaluate your overall health and review lab work.

What if I have difficulty affording PrEP or related medical care?

PrEP continues to become more accessible. In addition to the availability of generic PrEP options and expanded health insurance coverage of PrEP, the following resources can help lower the costs of HIV prevention medication.

Many states have patient assistance programs to help people with a variety of insurance statuses access PrEP and related medical services at little to no cost. Read our previous blog for more on how to apply for state-funded PrEP assistance programs.

Many medication manufacturers offer patient assistance programs to offset the cost of medication. For example, Gilead, the manufacturer of brand-name Truvada, has the Gilead Advancing Access® program, which offers a copay card for those with insurance and a Medical Assistance Program for those who are uninsured.

The Ready, Set, PrEP program provides PrEP at no cost to eligible individuals without insurance coverage of prescription medications.

Alto is here every step of the way to make it as easy as possible to follow the treatment plan your doctor recommends. Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started with oral PrEP and continue treatment.

We’re available to answer any questions you may have between your follow-up appointments. In addition, we will coordinate with your doctor and your insurance provider, if applicable, to ensure that you’re receiving the best PrEP option for your needs at the best price.

To learn more, reach out any time through Alto’s in-app messaging or 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.

If you’re managing a chronic health condition — or multiple conditions — you’re probably familiar with the hassle of filling multiple medications. Not only is it inconvenient to track different refill dates throughout any given month, it makes it much more difficult to prioritize your health, with the potential for missed doses.

To make it as convenient as possible to stay on track with treatment, Alto offers a free medication bundling service that lets you receive all your medications in a single, recurring delivery.

Medication Bundling: One Delivery for All Your Prescriptions

If you’re managing a chronic health condition — or multiple conditions — you’re probably familiar with the hassle of filling multiple medications. Not only is it inconvenient to track different refill dates throughout any given month, it makes it much more difficult to prioritize your health, with the potential for missed doses.

To make it as convenient as possible to stay on track with treatment, Alto offers a free medication bundling service that lets you receive all your medications in a single, recurring delivery.

Medication bundling builds on other tools in the Alto app like auto refills and medication reminders to take the hassle out of living your healthiest life. And like everything at Alto, it bridges innovation with industry-leading care to deliver an exceptional pharmacy experience that puts you first.

While some traditional retail pharmacies offer a similar service, they often require you to do the legwork of coordinating with your doctor and insurance. (Not to mention that there’s the additional inconvenience of traveling to the pharmacy and waiting in line.)

At Alto, it’s a whole lot simpler. The entire process takes place in the app, and if your medications are eligible*, we can organize your bundle within seconds.

We’ll get you started with synchronized refills and bundled deliveries in four simple steps.

1. If you have multiple prescriptions on file with Alto that qualify for bundling, you will be automatically prompted to bundle your medications when you log into the Alto app and we’ll sync your refills. (Have prescriptions at other pharmacies? Transfer them to Alto so we can add them to your refill schedule!)

2. We’ll ask you to confirm your medication list and current supply. Let us know if any of your medications are taken on an as-needed basis, or if any are urgently needed.

3. We’ll create a custom timeline for your synchronized refills. Depending on your insurance coverage, this may be once a month or up to every three months. If needed, we’ll schedule a partial fill upfront to avoid a delay in your treatment while we align your refills.

4. We’ll schedule all refills into a single delivery on your behalf and reach out on a recurring basis when your order is ready for delivery. As always, you’ll pick the delivery window that works best for your schedule.

Ready for one easy delivery? Transfer your prescriptions to Alto to start the medication bundling process today.

*Medication bundling is not available for some medications. In addition, some insurance plans may limit automatic refills.

Everyone should prioritize their heart health and take impactful steps to lower their risk of heart disease, a widespread and serious condition. For those with diabetes, it’s especially important to be proactive, as the condition doubles your risk of heart disease and stroke.

Understanding the Diabetes-Heart Health Connection

Read on to learn how diabetes affects heart health and what you can do to lower your risk of heart disease if you have diabetes.

The term heart disease refers to several different conditions that affect the heart:

Coronary artery disease — the most common type of heart disease — occurs when the blood vessels that supply the heart with oxygen-rich blood are hardened or blocked, affecting blood flow to the heart.

Peripheral arterial disease is characterized by a similar hardening of the arteries in the legs and feet. It is often the first sign of cardiovascular disease in an individual with diabetes.

Heart failure occurs when the heart cannot pump blood and oxygen as well as a healthy heart, often due to damaged heart muscle or blocked arteries.

A stroke occurs when the flow of blood and oxygen to the brain is blocked, often due to a blood clot or the accumulation of plaque in blood vessels.

Diabetes is one of several primary drivers of heart disease, along with uncontrollable risk factors like age and family history as well as controllable ones such as:

The connection between diabetes and heart health is twofold. First, it can directly increase your risk of heart disease, as high blood sugar — the defining feature of diabetes — can gradually damage your blood vessels and the nerves that control your heart.

Secondly, diabetes may increase your risk for other heart-related conditions, specifically:

High blood pressure, which occurs when the force of the blood flowing through your arteries is consistently too high, causing the heart to work harder. Damaged blood vessels as the result of diabetes can lead to high blood pressure. According to the American Diabetes Association, two out of three individuals with diabetes have high blood pressure or take blood pressure-lowering medication.

High levels of LDL cholesterol, which can also damage blood vessels over time, increasing the risk for heart disease and stroke. Elevated levels of cholesterol and other blood fats like triglycerides often go hand in hand with diabetes.

High blood pressure and high cholesterol are not accompanied with visible symptoms in many cases. For this reason, it’s important to stay on track with preventative screenings and to monitor your blood pressure and cholesterol levels.

If you have any condition that falls under the umbrella of diabetes — including prediabetes, type 1 diabetes, or type 2 diabetes — it’s important to learn the symptoms of heart disease. These are among the most common:

Heart disease presents differently from one individual to another. However, if you have diabetes and experience any of the symptoms above — especially chest pain or pressure, shortness of breath, or fatigue — it’s important to seek prompt medical care.

If you have diabetes, there are several steps you can take to lower your risk for heart disease. First and foremost, stay proactive about your diabetes treatment and work with your doctors to keep blood sugar levels in a healthy range.

There’s a useful acronym to help you remember important diabetic preventative actions — aka the ABCs:

A: Staying on track with the A1C test, which measures your average blood sugar levels over the past three months. Work with your doctor to identify your personal target range.

B: Staying on track with blood pressure screenings. Your doctor can help you understand your personal goal, however, a healthy range for those with diabetes is typically considered under 140/90 mm Hg.

C: Staying on track with cholesterol screenings and keeping LDL levels in a healthy range. As with your A1C and blood pressure levels, follow your doctor’s guidance regarding your personal target for cholesterol.

S: Avoid smoking, as it narrows your blood vessels, worsening diabetes and increasing your risk for heart disease. Ask your doctor for support with smoking cessation if needed.

In addition, follow a heart-healthy diet:

Opt for foods that are low in saturated fats and trans fats, which increase LDL cholesterol levels. Low-fat dairy products and chicken are healthier alternatives to full-fat dairy products and red meats.

Try to limit your sodium intake to 1,500 mg/day. Common sources of sodium include processed or prepackaged foods like soups, cold cuts, bread, and frozen meals.

When it comes to nutrition and diabetes, there isn’t a one-size-fits-all approach. The ideal balance of calories from carbohydrates, proteins, and fats varies significantly by individual, so it’s important to consult your doctor about the approach that best supports your treatment plan. Consider working with a nutritionist or diabetes educator, a healthcare professional with extensive knowledge of diabetes who is certified to provide individualized coaching.

In some cases, your doctor may recommend medication to treat or prevent heart disease, in tandem with the above lifestyle changes. Heart disease medications commonly prescribed to individuals with diabetes include:

Empagliflozin (Jardiance®) and dapagliflozin (Farxiga®) help those with type 2 diabetes maintain healthy blood sugar levels and manage heart disease.

Statins such as atorvastatin (Lipitor®), fluvastatin (Lescol®), lovastatin (Mevacor®, Altoprev®), pitavastatin (Livalo®), pravastatin (Pravachol®), rosuvastatin calcium (Crestor®), and simvastatin (Zocor®) help maintain healthy cholesterol levels.

Blood pressure-lowering medications including beta blockers, ACE inhibitors, ARBs, and diuretics may also be used to prevent or manage heart disease in individuals with diabetes.
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At Alto, we make it as simple as possible to manage your risk for heart health issues and stay on track with your individual treatment plan, whether it includes medications for diabetes, high cholesterol, or high blood pressure.

We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

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

While fertility treatments like in vitro fertilization (IVF) have become an increasingly common path to parenthood, helping millions of individuals conceive throughout the past four decades, they remain a significant financial investment.

How Alto Lowers the Cost of Fertility Treatment Through Better Medication Management

Fertility medications used to support egg production, retrievals, and implantations frequently factor heavily into the overall cost of treatment. An average IVF cycle costs between $10,000 and $15,000, with medications an additional $5,000 or more depending on factors like a patient’s age and health history and a clinic’s treatment approach. Unfortunately, a portion of these medications often go unused, as many fertility treatment plans involve last-minute medication changes unsuited for the traditional retail pharmacy model.

As part of our commitment to your financial well-being, we offer a medication management experience that reduces fertility medication waste to lower the cost of treatment, developed in collaboration with Progyny. Take a closer look at our approach.

IVF is a process in which eggs and sperm are fertilized and then placed into the uterus with the potential outcome of a pregnancy. Multiple medications are used on a precisely timed schedule to grow follicles — fluid-filled sacs in the ovaries that potentially contain an egg — retrieve eggs, and, finally, implant a fertilized egg into the uterus. 

Here’s a snapshot of a typical IVF medication schedule:

Days 1-4: stimulation medications such as Gonal-f®, Follistim®, Menopur®, or Low-Dose hCG to stimulate egg production, so that you produce multiple follicles

Days 5-10: continuation of stimulation medications and introduction of antagonists such as Fyremadel™ (ganirelix acetate) and Cetrotide® to prevent premature ovulation

Days 10+: trigger shots of leuprolide acetate, Ovidrel®, and/or Novarel®/Pregnyl® to stimulate final growth spurt and ovulation

After transfer: estrogen and progesterone to support successful implantation of the embryo

Fertility medications are complex, with nightly dosages dependent upon hormone levels measured through bloodwork and ultrasounds. Not only do medication protocols vary from one individual to another, they are typically adjusted throughout the course of a cycle as hormones fluctuate.

Unused medication during fertility treatment

To prevent any missed doses, providers typically prescribe all medications that could be needed in bulk at the beginning of fertility treatment. However, dosages often decrease once a cycle is underway based on a provider’s discretion, ultrasounds, and bloodwork.

At traditional pharmacies, patients undergoing fertility treatment might end up paying for unused medication, as all potential medications are filled upfront. This contributes to the $5.4 billion epidemic of medication waste in the U.S. — one that is particularly acute in fertility, leading some individuals to buy and sell excess medication to each other on social media sites.

Our approach to fertility medication management

Alto has partnered with fertility benefits manager Progyny on an algorithm-powered, app-based medication management experience that reduces unneeded fertility medications while protecting the integrity of time-sensitive and personalized treatment plans.

First, we collect fertility cycle information through the Alto app and run the data through the Progyny algorithm to determine exactly what medication volumes are needed for the next phase of treatment. We then prepare a custom order for just the medications that are immediately needed, which are then delivered directly to your doorstep by our courier team. 

You will receive multiple deliveries throughout the course of your cycle, determined by your specific dosing, trigger schedule and other inputs from your clinical team. Carefully timed check-ins and local courier delivery make last-minute adjustments possible. This approach allows you to manage your medications as your IVF cycle progresses, giving you more control over the total amount of medication that you fill.

Additional financial resources for fertility medications

Alto is committed to helping you save as much as possible on your fertility medications. In addition to our personalized medication management approach, we’ll automatically search for savings and connect you with programs that require you to apply directly, including patient assistance programs from fertility medication manufacturers.

If Alto is your fertility pharmacy, your fertility medication protocol likely includes medications manufactured by EMD Serono or Ferring Pharmaceuticals. EMD has several programs that lower the cost of fertility treatment, including the Compassionate Care program, which offers income-based assistance for fertility medications that aren’t covered by insurance, and special opportunities for military veterans and cancer survivors.

Ferring Pharmaceuticals also offers financial assistance programs to offset the cost of fertility medications, including the HeartTomorrow program for individuals who elect to freeze their eggs, and special opportunities for military veterans and cancer patients.

Read Managing the Costs of Fertility Treatment for more on Alto’s financial support for fertility treatment and medications.

Choose a flexible and reliable pharmacy partner

Fertility treatment can be challenging, but we’ll be with you every step of the way. To ensure that your treatment plan is followed correctly, we offer free same-day delivery of your medications and fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists.

Interested in learning more about how Alto can support your fertility treatment? Request a price quote online or reach out through secure in-app messaging or by phone at 1-800-874-5881.

With many variables involved in an individual’s fertility, learning more about your reproductive health can help you manage expectations about your body’s response to fertility treatment. The anti-mullerian hormone (AMH) test, which measures your body’s levels of a hormone associated with ovarian reserve, is one potential source of information for those experiencing infertility.

AMH Testing in Fertility Treatment

While the AMH test can reveal certain factors related to your reproductive health, it is not relevant to all aspects of fertility, or all types of fertility issues. Here’s more about the AMH test, including what it can and can’t tell you.

Anti-mullerian hormone is a hormone that affects how a baby’s reproductive organs develop while in the womb. Male babies have higher levels of AMH than female babies.

AMH is also related to a woman’s ovarian reserve. Cells inside the ovarian follicles — fluid-filled sacs that release an egg during ovulation — produce AMH. An individual's levels of AMH correspond to their egg count, with higher levels of the hormone typically indicating a higher ovarian reserve.

Unlike many other hormones related to reproductive health, AMH levels remain steady throughout an individual’s menstrual cycle. This means that you can have your AMH levels measured at any time, unlike some other fertility-related blood tests.

An AMH test is a blood test that measures your levels of AMH, revealing the approximate number of eggs in your ovarian reserve that may be used for ovulation. It provides a snapshot into one aspect of your fertility, rather than a precise look at the whole picture.

The AMH test consists of a simple blood draw. It typically takes about a week for test results to arrive. There are at-home AMH tests available, however, it is important to discuss the results with a healthcare provider.

Below are general ranges of AMH levels, measured in nanograms per milliliter. Your provider can give you a clearer sense of what your AMH levels indicate.

An AMH test is an indication of the number of eggs remaining in your ovarian reserve. This is particularly relevant to in vitro fertilization (IVF), since one goal of IVF is to retrieve as many mature eggs for fertilization as possible. Your AMH test results may also inform your individual medication protocol for IVF, as they can help your provider anticipate your body’s response to ovarian stimulation medication.

The AMH test can also indicate the pace at which your ovaries are aging.

While AMH levels are helpful for determining egg quantity, they do not reveal anything about the quality of your eggs. Egg quantity factors into IVF success rates — the more eggs retrieved, the higher your chances are of producing multiple healthy embryos that may be placed into the uterus — but quality is also extremely important. It is possible to have a low ovarian reserve but a high percentage of viable eggs, in which case a successful IVF cycle would be more likely.

It is also possible to experience infertility despite having normal AMH levels. Other factors that may affect your ability to conceive include your age, lifestyle habits, ovulation disorders, uterine abnormalities, and endometriosis, among others. Sperm count and mobility also factor into a couple’s fertility. There are many diagnostic tests a reproductive specialist may use to evaluate your remaining egg supply and recommend the best treatment plan.

Read Infertility, Explained for a more comprehensive overview of common fertility issues.

A fertility pharmacy partner you can rely on

At Alto, we’re here for you at every step of your fertility journey. We offer free same-day delivery of your medications, with discreet packaging, fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists, and support with insurance and savings opportunities.

To learn more about how Alto can support your fertility treatment, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

Polycystic ovary syndrome (PCOS) is a condition that affects women of reproductive age and is characterized by a hormone imbalance. It can impact many areas of a woman’s health, including menstrual cycles, fertility, insulin levels, and risk of cardiovascular disease.

How Polycystic Ovary Syndrome (PCOS) Affects Fertility

Symptoms of PCOS can be treated through a combination of medications and lifestyle changes. Here’s what to know about the condition’s causes, symptoms, and treatment options.

Polycystic ovary syndrome has three defining symptoms: high levels of male hormones, irregular menstrual cycles, and the development of cysts in the ovaries. These features overlap.

Many women with PCOS have higher levels of androgen hormones, which are responsible for the development of certain male characteristics. For those with PCOS, overproduction of androgens leads to irregular menstrual cycles, hair loss, extra growth of hair on the face and body, and acne.

The cysts that develop in the ovaries are small follicles containing an immature egg. Since these eggs do not reach maturity, ovulation — the release of a mature egg from the ovaries — does not occur. The absence of ovulation leads to further imbalance of hormones, as progesterone decreases.

PCOS is the leading cause of female infertility.

Polycystic ovary syndrome can develop at any age after puberty. It is estimated that 5-10% of women between the ages of 15-44 have the condition.

The specific causes of PCOS have not been identified, but the medical community believes that condition is the result of several intersecting factors: insulin resistance, higher levels of androgens, higher levels of inflammation, and an irregular menstrual cycle.

Some evidence suggests that PCOS may have a genetic component. You may have a higher risk of developing PCOS if you have a mother, sister, or aunt with the condition. Obesity is also a risk factor.

Common symptoms of polycystic ovary syndrome include:

Irregular, absent, or abnormally short (i.e., less than 21 days) menstrual periods

Excess hair on the face, chin, chest, abdomen, or upper thighs, also referred to as hirsutism

Weight gain or difficulty maintaining a healthy weight

Patches of darkened skin, particularly on the neck, in the groin, and beneath the breasts

Small flaps of excess skin near the neck or armpits, sometimes referred to as skin tags

Infertility, defined as the inability to get pregnant after twelve months or more of unprotected sex

The hormone imbalances that characterize PCOS can affect many areas of a woman’s health, including the following.

Infertility is a common symptom of PCOS, as hormone levels interfere with ovulation, an important step in reproduction. However, PCOS is a highly treatable cause of infertility. Many individuals and couples affected by PCOS do become pregnant after fertility treatment.

During pregnancy, women with PCOS may face a greater risk for miscarriage, high blood pressure, and gestational diabetes. They are also more likely to deliver prematurely. If you have PCOS, you can set yourself up for a healthy pregnancy by maintaining a healthy weight and blood sugar levels before trying to conceive and during pregnancy.

Insulin is a hormone naturally produced in the pancreas. It helps convert sugar, or glucose, into energy. Type 2 diabetes occurs when blood sugar levels rise due to issues with the body’s production or use of insulin. Since insulin resistance is often a symptom of PCOS, many individuals with the condition have a greater risk for type 2 diabetes.

Individuals with PCOS are also more likely to develop metabolic syndrome, a group of conditions associated with a higher risk for diabetes and heart disease, including:

Abnormal cholesterol or triglyceride levels

Endometrial hyperplasia, a condition in which the lining of the uterus becomes too thick, is also associated with PCOS. It can increase a woman’s risk for endometrial cancer.

The process for diagnosing PCOS includes a conversation about your health history, a physical exam, and several tests that can rule out other causes of PCOS symptoms.

During the physical exam, a healthcare provider typically measures blood pressure, body mass index (BMI), and waist size. They will also check your skin for extra hair, acne, or discoloration.

Your doctor will likely conduct a pelvic exam to check for signs of high androgen levels and abnormalities with your ovaries. Then, a pelvic ultrasound, or sonogram, will check the ovaries for cysts and scan the uterine lining.

Blood tests may be used to measure levels of androgens as well as hormones linked to other health conditions with similar symptoms as PCOS. You may also be tested for high cholesterol and diabetes.

If other health conditions have been ruled out, you must have at least two of the following symptoms to be diagnosed with PCOS:

Irregular, absent, or abnormally short menstrual periods

Signs of high androgen levels such as hirsutism, acne, or thinning of hair on the scalp

PCOS and related medical conditions can be managed through a variety of treatments including medications and lifestyle changes. Treatment is tailored to an individual’s health history, PCOS symptoms, and reproductive goals. Here’s how different treatment options target various symptoms of PCOS.

Hormonal birth control, which may contain both estrogen and progestin, is often used to regulate a woman’s menstrual cycle. It can also reduce hirsutism and acne and lower the risk of endometrial cancer. Many women who do not have plans to get pregnant use hormonal birth control as a long-term treatment for PCOS.

Metformin, an oral medication most commonly used to treat type 2 diabetes, is sometimes used off-label to treat PCOS. It improves the body’s response to insulin and can lower blood sugar and androgen levels. In some cases, it may be effective at restoring ovulation, though it typically does not treat hirsutism or acne.

Anti-androgen medications such as spironolactone (CaroSpir® and Aldactone®) block the effects of androgens and treat hirsutism. They are often used in combination with birth control and should not be used during pregnancy or when trying to conceive.

Maintaining a healthy weight can help regulate menstrual cycles. It may also improve insulin levels and treat excess hair growth and acne. Additionally, following a heart-healthy diet and staying physically active is especially important for those with PCOS.

In many cases, metformin or lifestyle changes can help address ovulation issues associated with PCOS. There are additional treatments that restore ovulation in women with PCOS, including oral medications used to treat infertility such as Clomid® and Femara® and injectable fertility medications including gonadotropins.

A procedure called laparoscopic ovarian drilling is a fertility treatment typically reserved for cases when medication is not effective.

PCOS treatment looks different for each individual, and our team has the expertise to support your personal health journey. Whether you are getting started with hormonal birth control, metformin, or fertility treatment, we’re here to simplify medication management and keep you supported.

We offer free, same-day delivery seven days a week, with temperature controlled packaging that ensures fertility medications always arrive in the right condition. And we’ll work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

Resting heart rate varies from one individual to another, but the healthy range for an adult is 60-100 beats per minute. In some cases, issues with the heart’s electrical signals that trigger a heartbeat can cause an arrhythmia. This means that the heart beats too quickly, too slowly, or irregularly.

Atrial Fibrillation, Explained

Atrial fibrillation, often referred to as Afib, is a rapid heart rate caused by irregularities in the heart’s upper chambers, or atria. It is the most common type of arrhythmia. Though the condition increases the risk of having a stroke, it is treatable with a combination of medications, lifestyle changes, and non-surgical and surgical procedures. Here’s what to know about the causes, symptoms, and treatment of atrial fibrillation.

The heart’s natural pacemaker, the sinus node, is located in the upper right chamber. It triggers the signal that begins each heartbeat. Normally, the signal travels from the sinus node through the two atria and into a pathway between the upper and lower chambers. As it travels, your heart will contract, transporting blood both to and from the heart.

Atrial fibrillation begins in the heart’s upper chambers. The signals in the atria are irregular, which causes the upper chambers to shake. As signals try to enter the lower chambers, a fast and irregular heart rhythm is produced.

There are different types of atrial fibrillation categorized by their duration.

Paroxysmal Afib lasts for less than a week and typically does not require treatment.

Persistent Afib is continuous, lasting longer than a week but less than a year. Treatment is required.

Permanent Afib is continuous and treatment-resistant.

Most cases of atrial fibrillation stem from issues with the structure of the heart. These structural issues may be caused by coronary artery disease, a heart attack, a congenital heart defect, or heart valve disease. However, it is possible to develop the condition without a history of heart health issues.

The following risk factors are often linked to atrial fibrillation.

Other health conditions including diabetes, chronic kidney disease, lung disease, or sleep apnea

Not all cases of atrial fibrillation have noticeable symptoms. In some cases, one or more of the following symptoms may develop.

As many as 1 in 3 people with Afib may not know that they have the condition. It’s important to understand the condition’s risk factors and discuss your individual risk with your healthcare provider.

Due to the potential for blood clots, atrial fibrillation can lead to a greater risk for stroke. The irregular heart rhythm that characterizes Afib can lead to the accumulation of blood and the formation of clots in the upper chambers. If a clot breaks off from the heart, it may travel to the brain, causing a stroke.

The risk of a stroke related to Afib increases as you age. Having other conditions such as high blood pressure, diabetes, or heart failure in addition to Afib may also increase your risk for a stroke. Staying on track with treatment and following your doctor’s recommendations is the best way to manage this risk.

Many types of atrial fibrillation are treatable. Treatment often consists of a combination of medication, lifestyle changes, and, in some cases, non-surgical procedures or surgery. Several types of medications are used to treat Afib.

These medications prevent the formation of blood clots and treat existing clots. Commonly prescribed antiplatelets and anticoagulants include:

Direct-acting oral anticoagulants (DOACs) such as apixaban (Eliquis®), dabigatran (Pradaxa®), edoxaban (Savaysa®), and rivaroxaban (Xarelto®)

Beta blockers and calcium channel blockers may be used to manage atrial fibrillation by controlling an individual’s heart rate. Commonly used to treat high blood pressure, beta blockers cause the heart to beat more slowly and less forcefully. Examples of beta blockers include:

Blog

What to Know About PrEP Follow-Up Appointments and Testing

Medication Bundling: One Delivery for All Your Prescriptions

Understanding the Diabetes-Heart Health Connection

How Alto Lowers the Cost of Fertility Treatment Through Better Medication Management

AMH Testing in Fertility Treatment

How Polycystic Ovary Syndrome (PCOS) Affects Fertility

Atrial Fibrillation, Explained

A Full Pharmacy At Your Doorstep: Introducing Essentials from Alto

The Evolution of HIV Medication

The Medicare Donut Hole, Explained

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