Gynecology Questions

Do I need to reschedule my pap smear if I have my period? We use the ThinPrep liquid-based pap. You can have a pap smear if you have your period as long as the flow is not very heavy.

How do I know if I have a yeast infection? It is normal to have vaginal discharge and it is normal for it vary throughout the month. Your discharge may be abnormal if it heavier than normal and is associated with persistent itching, burning or a foul odor. If you have these symptoms, please call for an appointment.

What is a Colposcopy? A Colposcopy is a diagnostic tool to determine the cause of abnormalities found in Pap smears.  A colposcopy is a visual examination of the cervix, a relatively simple and painless procedure, usually performed in our office.  The actual procedure lasts approximately ten to fifteen minutes.

When do I need to start getting mammograms? Women age 40 and older should have mammograms every 1 to 2 years. Women an increased risk of breast cancer should talk with their doctor about whether to have mammograms before age 40.see Cancer.gov

Taking Birth Control Pills Each package has 21 hormone pills and 7 non-hormone pills, or sugar pills.  Your period will usually occur while taking the non-hormone pills.  Take one pill every day at the same time of the day until you finish the package and then start a new package of pills.

 

Some brands of birth control pills contain only 21 pills.  If you receive this type of pill, you need to take the pills for 21 days, stop taking pills for 7 days, and then begin the new package.

You may want to try to associate taking your pill with something else that you do every day about the same time.  For example, eating a certain meal, getting up or going to bed or brushing your teeth.  Pills work best if you take them at the same time every day, and making it a part of your daily routine can make this easier.

 

STARTING THE PILL

 

Start your first package:

  • The first Sunday after the first day of your next period.  If your period starts on a Sunday, start the pills on that Sunday.
  • If you just had a baby, you can start your pills the fourth Sunday after you delivered the baby.

 

PROTECTION FROM PREGNANCY

 

A back up method of birth control (that is, condoms & foam) is recommended during the first package of pills, whenever you forget pills (see below), or when you take certain medications (see below).

 

If you have diarrhea or vomiting, use a back up method of birth control during your illness until you get your period.  Illnesses that cause vomiting and diarrhea can interfere with the effectiveness of the birth control pill.

 

MISSING A PILL

 

If you miss one pill, take the forgotten one as soon as you remember and take your next pill at the regular time (this may mean taking two pills at once).  You will probably not become pregnant, but just to be sure; you may want to use a back up method for 7 days after the missed pill.

 

If you miss two pills, take two pills as soon as you remember and two pills the next day.  For example, you miss pills on Saturday and Sunday, but remember on Monday, take two pills Monday and two on Tuesday.  You may have some spotting.  Use a back up method of birth control for 7 days after two missed pills.

 

If you miss three or more pills, you may want to consider if you are a good pill user.  Another form of contraception is needed, as the risk of accidental pregnancy is great.  You may begin your period.  Whether or not you are having your period, throw away the pack and begin the new package the Sunday after your period begins and use a back up form of birth control during the first package.

 

If you miss a pill during the 4th week (only) of a 28-day pack, simply throw away the missed pills and begin a new package on schedule.  The pills in the 4th week do not contain hormones, so missing pills during this week does not increase the risk of pregnancy.

 

NO PERIODS/SPOTTING

Sometimes you may miss a period while taking birth control pills.  Even one drop of blood or a brown smudge on a pad or underwear is considered a period while you are on the pill.  If you have faithfully taken your pills, the risk of pregnancy is unlikely.  If you missed pills and missed a period, you will need a pregnancy test before beginning a new package of pills.  Also, if you miss two periods in a row, you will need a pregnancy test.

 

Spotting or light bleeding may occur in the first three packages of the pills.  If it persists for three or more cycles, call the clinic since you may need a different pill prescribed.

 

MINOR SIDE EFFECTS

It is common to notice these side effects in the first three months of the pills.  These usually disappear after the first three packages of pills.  Keep taking your pills for those three cycles, and if you are still experiencing these side effects, contact your provider:

 

  • Nausea
  • Mood Changes
  • Spotting
  • Breast tenderness
  • Weight Gain or Loss

 

SEVERE SIDE EFFECTS

Contact your emergency room or urgent care clinic if you experience any of these side effects while on birth control pills:

 

  • Severe abdominal pain
  • Severe chest pain or shortness of breath
  • Vision changes (blurring, flashing lights or blindness)
  • Severe headaches
  • Severe leg pain (calf or thigh, usually one leg)

 

NUTRITION

Birth control pills may alter a woman’s metabolism and change her needs for certain nutrients.  Women taking birth control pills should increase their intake of vitamin B6, folic acid and vitamin C.

 

Foods rich in Vitamin B6 include:  meat, fish, eggs, poultry, dark green leafy vegetables, legumes, dairy products, bananas, potatoes, whole grains, and tomato juice.

 

Foods rich in Vitamin C include:  citrus fruits, dark green vegetables, tomato juice and broccoli.

 

USE OF OTHER MEDICATIONS

Other drugs, especially some antibiotics (tetracyclines and penicillins), anticonvulsants, or sedatives may cause a decrease in the effectiveness of the birth control pills. A back up method of birth control is recommended while taking these medications.

 

SEXUALLY TRANSMITTED DISEASES

While birth control pills are a highly effective means of birth control when taken regularly, they offer NO protection against sexually transmitted diseases (STDs) such as HIV/AIDS, HPV, chlamydia, gonorrhea, herpes, or genital warts.  STDs can cause severe infections leading to sterilization.  Using latex condoms and a spermicide (nonoxynon-9) can reduce your risk of being infected with an STD.

 

SMOKING AND THE PILL

 

While cardiovascular complications (such as high blood pressure, stroke, heart attack) from the pill are rare, they are more likely to be found in women who smoke.  If you smoke, we recommend you attend a smoking cessation program and quit.  Women who are over age 35 and continue to smoke can no longer take combined birth control pills.

 

OTHER BENEFITS OF BIRTH CONTROL PILLS

 

  • Lighter menstrual periods
  • Decreased menstrual cramps
  • Some protection against ovarian and uterine cancer
  • Relief of some PMS symptoms
  • More regular menstrual cycles

 

RETURN OF FERTILITY

Fertility usually returns within 2-3 months after stopping birth control pills.  Taking a break from pills periodically is not recommended and will not increase fertility.

 

IF YOU HAVE ANY QUESTIONS ABOUT BIRTH CONTROL PILLS, PLEASE CALL AND SPEAK TO ONE OF THE CLINIC NURSES OR MAKE AN APPOINTMENT TO SEE YOUR HEALTHCARE PROVIDER.