Questions about Birth Control
and
Pregnancy Prevention
What options do I have for birth control? There are many birth control options available in the United States. See the following website and click AContraceptive Choices” for more detailed information on all types of birth control, advantages, disadvantages and new developments (www.managingcontraception.com).
Options include:
- Birth control pills*: combined pills or progestin-only pills
- Depo Provera contraceptive injection* (every three months)
- Contraceptive patch (*available by prescription, may be available late summer/fall 2002)
- Intrauterine device (IUD)
- Condoms*
- Diaphragm*
- Spermicides*: foam, film, suppositories
- Tubal sterilization or vasectomy
-Vasectomy education and referrals depending on funding
- Abstinence
- Fertility awareness method (Rhythm method)
* indicates contraceptive method supplies that are available at the health department’s Women’s Preventive Health Clinic.
Do birth control pills cause weight gain? Generally, birth control pills do not cause weight gain in women. This has been studied extensively with weight gain compared in women on birth control pills versus women not taking pills. These studies show that there is no difference in weight gain among women on pills and those not taking pills. Many women may experience some fluid retention or Awater weight@ of 2-6 pounds when they first begin pills. Weight gain occurs in most women from poor eating habits, excess calories and lack of exercise. Woman on pills who claim they gain weight from the pills may have gained because (1) they are eating more and taking in more calories and/or (2) they are experiencing changes in metabolism normally experienced by women as they age.
What is the Amorning after pill@ or emergency contraception? Emergency contraception is pregnancy prevention after unprotected sex, suspected contraceptive failure, or rape. Emergency contraceptive pills (ECPs) are higher doses of birth control pills that may be taken within 72 hours after unprotected intercourse to avoid becoming pregnant. While ECPs prevent most of the pregnancies that follow a single act of unprotected intercourse, they are nowhere near as effective as ongoing contraceptives and are not to be considered as a routine method of birth control. ECPs are available at the Women=s Preventive Health Clinic and require a brief history and pregnancy test before being given.
What are common side effects of birth control pills? Nausea, headaches, mood changes, decreased libido or sex drive, breakthrough bleeding or spotting, breast tenderness, mild bloating or feeling of fluid retention. Although these are possible side effects, most women experience very few side effects.
What are common side effects of Depo Provera (Depo)? Various changes in menstrual bleeding (spotting or breakthrough bleeding, no bleeding, irregular bleeding, missed periods), weight gain, headaches, breast tenderness, decreased libido or sex drive, moodiness or depression.
These are possible side effects. Many women on Depo do not experience bothersome side effects at all. Many side effects, like bleeding improve with time. Not everyone gains weight and some patients maintain the same weight or lose weight on Depo.
Do birth control pills or Depo Provera make you sterile? No. They have been used safely for decades by millions of women worldwide. Depo is a long-term method of birth control and it may delay a woman’s ability to become pregnant after it is stopped (on average 9 months). Depo and birth control pills do not make women sterile or unable to get pregnant.
What do I do if I think I am pregnant? Pregnancy testing is available at the health department without an appointment (walk-in) between the hours of 8-11am and 1-4pm Monday thru Friday. We encourage you to call and speak with a nurse about your concerns or talk with someone you trust. NEVER ignore or deny that you might be pregnant. Seek health care services that can assist you as soon as possible. If you had sex without birth control in the last few days, see question on Emergency Contraception.
How long does it take for a pregnancy test to become positive? At least 7 days late for your period.
Questions about Vaginal Health
How often should I douche? Is it okay to douche? A douche is a stream of liquid directed into the vaginal cavity for cleansing purposes. Some women use douching to feel cleaner or to help remedy an odor or discharge from the vagina.
Douching is not recommended for women because it is not needed for cleansing of the vagina and can actually result in vaginal infections or pelvic infections. Why? Douching washes out the normal “good” bacteria in the vagina and may disrupt the normal pH balance, causing growth of germs or organisms like yeast or bacteria. There are no health benefits whatsoever to be gained from routine douching. Douching may be harmful if it delays care for sexually transmitted or vaginal infections. See question – What is normal vaginal discharge?
It is very normal for the vagina and vaginal discharge to have a slight odor. Women need to promptly report an abnormal odor or definite change in the vaginal odor or vaginal discharge to their health care provider. The vagina cleans itself naturally; and normal hygiene with washing externally is all that is needed for vaginal health.
Is it normal to have discharge or mucus from the vagina? What is normal vaginal discharge? Yes, the vagina produces fluid or a discharge in all women. Discharge normally is white, clear or cloudy in color. A normal discharge dries to a clear or slightly yellow color and has a mild, but not bad odor. Discharge may look brown for a few days towards the beginning or end the menstrual period. Discharge may change slightly during the month and be more creamy or mucus-like, thicker or thinner at times. The amount of discharge may be different for each woman.
You should report to a nurse or health care provider if you notice any of these changes: (1) strong odor, increased odor (2) increased amount of discharge that persists (3) itching, burning, irritation, or swelling of the vagina (4) discharge that changes color or is yellow (5) clumpy or very thick discharge that is different than your normal discharge (6) changes in the discharge associated with pain with sex or pain in the abdomen.
Questions about services in Women’s Preventive Health
I had a recent physical with my private physician’s office, can I get my birth control (i.e. pills, Depo shot) at the health department? No. In order to receive birth control supplies at the health department you must be a patient in the Women’s Preventive Health Clinic and have a physical exam at the health department each year. A health care provider at the health department cannot rely on someone else’s exam in order to prescribe you medicines. In certain cases, previous records are reviewed and particular tests may not need to be repeated, but our staff must conduct your physical exam if you are to receive birth control.
How much do I have to pay for an exam and birth control at the health department’s Women’s Preventive Health Clinic? Services are based on income and are calculated on a sliding scale fee (and may be no cost for some income levels). Women’s Preventive Health does accept Medicaid, insurance, visa or mastercard, and debit cards.
Do I need my parents’ permission to receive services at the Health Department? No. We always encourage communication between parents and teenagers. However, according to North Carolina State law, minors can receive services for prevention of pregnancy without their parents’ consent. Our services are always provided in a confidential manner to all patients. By N.C. law, health care services that involve pregnancy prevention, treatment and diagnosis of sexually transmitted infections, and substance abuse do not require a parent’s consent.
Questions about Mammograms, Breast Exams and Pap Smears
How often should I have a mammogram? Women should have a baseline mammogram around the age of 35. From 40-50 years of age, women should have a mammogram every one to two years and after 50 years of age every year.
When is the best time to do a breast self-exam? The best time to do your breast exam is right after your period when your breasts are not tender or swollen. If you do not have regular periods, choose a day and do your exam the same time each month. If you find any lumps or other changes in either breast, tell your nurse or health care provider right away. Every woman should have a breast exam performed by a health care provider every year.
What is a Pap Smear? A Pap Smear (or Pap) is a specific test taken during a pelvic exam. It is a screening test for cervical cancer only. Pap Smears DO NOT screen for sexually transmitted diseases. The Pap Smear involves collecting cells from the cervix and is virtually painless.
When should I start having a Pap Smear and how often should I have a Pap? The American Medical Association and the American Cancer Society recommend that all women who are or who have been sexually active; or who have reached 18 years of age should have a Pap Smear and pelvic examination each year.
What do I do if my Pap smear is abnormal? You need to discuss this with a nurse or health care provider and have them explain the abnormal findings. Abnormal Paps do not mean you have cancer, just changes in the cells on the cervix. If you are told you have an abnormal Pap, NEVER IGNORE IT. Always ask questions so you understand what to do and follow-up as directed. A nurse or health care provider can explain whether the Pap Smear needs to be repeated in several months or you must be seen by a specialist.