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Ask Emma! Answers-Birth Control/EC | |
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Any health information contained in this service is not intended or implied to be a substitute for professional medical advice. Nothing contained should be used for medical diagnosis or treatment. If you have an urgent medical problem call 911 or contact your health care provider. General Birth Control Questions
Do you have to get
blood work done to get on birth control? Questions about Emergency Contraception
What's the
difference between the morning after pill and the abortion pill? Questions about Condoms
Are "Dollar
Store" condoms safe? Questions about the Birth Control Pill
Summary of all:
"I messed up taking my pills, could I get pregnant?"
questions. Questions about the Patch
Is it
normal to have increased desire on the patch? Can you wear 2 at once? Question about Depo Provera
Is
Depo affected by antibiotics like the pill is? Questions about Withdrawal
Should I
worry about pregnancy if he didn't ejaculate in me? Question about the Sponge Where is the cervix located in the vagina? How can I be sure the sponge is in the right place? Questions about Using Birth Control to Skip Your Period
I don't
want to have my period next week. Can I delay or skip it?
Questions about the IUD General Birth Control Questions "When you go in to get birth control at your clinic do you have to get blood work done?"
No you don't. The exam to get on birth
control consists of a pelvic exam, a pap smear, and a general physical
exam including listening to your heart and lungs. Blood tests aren't
necessary, and it's not general practice anywhere for a birth control
exam. The only things that we test for here with blood are syphilis,
hepatitis, and we can run cholesterol and blood glucose tests, and
again, none of those are routine at an annual (pap smear) exam. If you
would like any of those tests run, you have to ask.
"While being on the birth control pill, are there safer days to have sex?" "I hear that women with regular 28 day cycles usually ovulate around day 14 of the cycle. Does this mean that a woman on the birth control pill would ovulate during that time?" I assume that you are asking about being safer from pregnancy. As long as you take birth control pills (or any hormonal birth control) correctly, then you shouldn't ovulate at all. When women do ovulate on the pill it's usually because they missed a pill, or took it several hours late, and then that drop of hormones brought on ovulation. But that ovulation happens around the time she missed her pill, not necessarily mid-cycle. It is true that women with perfectly regular, 28-day cycles usually ovulate about 14 days after their period starts. However, no one should use just that fact as a birth control method, as any number of things can make ovulation change that one month.
Remember that there is no day that is safe from STIs. Always use condoms
EVERY time you have sex to prevent getting STIs. Using condoms
every time you have sex also helps protect you against pregnancy. Pills
are rated 99.9% effective at preventing pregnancy. While that is very
good, it's not 100%, and even when women take the pill perfectly, they
occasionally do get pregnant.
You are right about the lambskin condoms. They are very porous (they have small holes in them) so they are very ineffective at preventing pregnancy and sexually transmitted infections (STIs). There are other non-latex options though. Now there are condoms available made of polyurethane. This is a kind of plastic. They rated to be very close in effectiveness to male condoms. Some people prefer these to latex condoms, even if they don't have the allergy, since these are often thinner than the latex. Polyurethane is a much more expensive product than latex, so these tend to be quite expensive. The Reality Female Condom is also made of polyurethane, so it's safe for people with latex allergies. These aren't quite as effective as male condoms at preventing pregnancy, but they are still very effective. Women tend to like this, because they are in control of the protection, and female condoms can be put in several hours before intercourse, so they don't have to interrupt lovemaking. Like the polyurethane condoms, they can be a bit expensive.
You may want to experiment with other latex condoms too. Sometimes
people will use a certain brand of condoms, they won't be comfortable,
and the person will assume they are allergic to latex. This is very
common with spermicidically lubricated condoms, or flavored condoms.
"Can you still get pregnant even if you
are on birth control?" Yes. The most common reason women become pregnant while on birth control is when they take it incorrectly or inconsistently. For instance, if women take their birth control pills at a different time every day, if they occasionally forget to take it, if they forget to change their patch or it comes off, if they are late for getting their Depo shot, if they put in their diaphragm or cervical cap incorrectly, if they put on the condom wrong, and lots of other ways.
But, even if women use their birth control perfectly they will
occasionally become pregnant anyway. The birth control pill, for
instance, is rated more than 99% effective when used perfectly. That's
an incredibly good rating, but it still means that some women will
become pregnant, even if they do everything right. In groups of women
who do not use it perfectly, which is very common, the incidence of
pregnancy is much higher. Except for abstinence, there is no birth
control method that is 100% effective.
As far as your first question, regarding which birth control method is right for you, that's something that you have to decide for yourself or with the help of your doctor. There's not one that works best for 14 year olds, and another that works best for 30 year olds. It's all based on the individual and what's best for them. Do you think you will be able to take a pill at the same time everyday? If you don't think that will work for you, then the patch or Depo would probably be better options for you. When you do go and see the gynecologist, you should talk over your concerns about birth control with them, and they will take your concerns and your medical history into account to help you find a birth control method that is right for you. No matter whether your gynecologist decides that the pill, the patch, the ring, or Depo would be best for you, remember that you still need to use condoms each and every time that you have sex. Hormonal birth control provides absolutely no protection against sexually transmitted infections (STIs). As for how to tell you mother, I don't know that I have anything you will want to hear. If you truly just want to be on birth control to regulate your periods, than I think that you should tell her that. If you have had a doctor recommend birth control for that purpose, then you can bring that recommendation to her. Even if you bring her a note from a doctor saying that the only reason that you want birth control is to regulate your periods, there's no guarantee that your mother won't assume that you want to be protected against pregnancy as well. Here's my advice, and keep in mind, that I don't know anything about you and your mother's relationship, and this may not be applicable to your relationship. My advice is to be open and honest. If you want to be on birth control because you are or are going to be sexually active (even if you want it to regulate your periods also), then tell her that. Sure, she may be shocked by this information, and she may be angry when she first hears it. But she may also be very proud of you for being mature and grown-up enough to tell her and to get protection, rather than going without birth control. The other option, is to call your gynecologist or your local reproductive health clinics, to see if you can get birth control without your parent. In many states, you don't need parental permission to get birth control. I do recommend that you use that as a last resort, and try to include your parent if possible. Even if you get birth control without her, she could find that pack of pills down the road, and not only be mad that you're on birth control, but that you didn't tell her.
Since you said you have been mulling this over for 5 months, I would
recommend that you just get this over with. Especially if you are
sexually active, it would be very unfortunate if you became pregnant
because you were putting off this conversation with your mother. As
intimidating as the birth control conversation would be, think of how
scary it could be to tell her that you are pregnant. Just try to relax
about it, and be as honest as you can be. Remember that some mothers are
very proud of their daughters for taking responsibility. This
conversation may not end up being nearly as bad as you have been
building it up to be. Good luck.
This is a question that is causing some controversy (and confusion) nationwide, mostly because it depends on each individual's definition of conception, abortion, contraception, and when life begins. The first issue is to try to define some of these notions. In a previous post, I discussed the different definitions of conception and when pregnancy begins. Click here to read the full post, but the gist of it is that most medical definitions say that pregnancy begins when the fertilized egg implants in the uterus. The reason it doesn't begin when the sperm meets the egg, is because many of these fertilized eggs don't implant in the uterus even when women aren't on any hormonal birth control. As many as 50% of fertilized eggs leave the body without implanting. It becomes really overcomplicated to say that each of these eggs was a pregnancy, when the woman involved will most likely not miss her period or have any way of knowing that she was ever "pregnant". Hormonal birth control (pill, patch, ring, shot), if taken correctly, are meant to prevent a woman from ovulating. Thus, in most circumstances, there should be no eggs to fertilize, and this isn't an issue. One of the other things that the pill does is cause the uterine lining to be thinner, so that in the case that an egg is released and is fertilized, it is less likely to implant in the uterus. Again though, up to 50% of fertilized eggs don't implant, even when women aren't on hormonal birth control. Also, a lot of fertilized eggs implant anyway, since many women do become pregnant even when they were taking hormonal birth control.
But, back to what I said in that first paragraph, everyone has their own
definitions of all these terms, and no matter what, anything relating to
pregnancy is going to be controversial. To answer your question, we
don't consider hormonal birth control abortive, but there are some
people who do. The best thing is to just do your own research, and make
decisions regarding what birth control you would like to use for
yourself.
In the state of Iowa, women under 18 do not have to notify their parents before going on birth control or seeing a gynecologist. The biggest problem that young women have when they choose not to inform their parents, is paying for the required exams and the birth control. Many young women do not want to use their insurance, because they don't want their parents finding out. If you do have insurance, you should call the customer service phone number on your card. First, you should ask if your policy covers gynecology exams and birth control. If they do cover these services, you should ask them about having your medical records kept confidential. Everyone has the right to have their medical records kept confidential, even from the people who hold your insurance policy. Just talk this over with the customer service representative of your insurance company and they'll tell you all about how it works and what these visits will look like on your parents' insurance statements. If you can't use the insurance, or if you don't have insurance, you have some more research ahead of you. First you should call around to different health care providers to find out where you can find the most affordable exam. Here at the Emma Goldman Clinic we have half-priced gynecology exams for teenage women, which will help significantly with these costs. When you do get your birth control prescription, make sure you call around to lots of different pharmacies to find out which one has the best price for your birth control. Pharmacies can vary widely in price, so it's important to shop around. Remember, that even when you go on the pill (or any other hormonal birth control method) you still need to use condoms each time that you have sex. Hormonal birth control does not protect you at all against sexually transmitted infections (STIs). Also, if you're in the habit of using condoms regularly, then you are protected against pregnancy in cases of if you forget to take a pill, or if you are put on antibiotics or other medications that lessen the effectiveness of birth control.
Good luck. If you have more questions, feel free to call us here at the
clinic.
You have a whole lot of questions here. I do want to say that it's really good that you're doing all this research before you have sex. Most barrier methods (diaphragm, male or female condom, sponge, cervical cap) do involve you touching your vagina. Remember that your vagina is a part of your body just like your fingers, your face, your belly button, your toes, etc. For some women it helps to think that putting their fingers in their vagina, to put in a diaphragm for instance, isn't all that different than reaching in the back of your mouth to floss your teeth. Yes, you're sticking your fingers into a moist orifice (bodily opening), but it's something you have to do. Also, remember that having sex involves putting a man's penis in your vagina. That kind of makes your own fingers seem like not so big of a deal. If you do decide to go with the diaphragm, you will have to go to a health care provider/gynecologist to get fit for it, since there's several sizes. Ideally, at this visit, your practitioner will also instruct you on how to easily insert/remove the diaphragm, and help you out if you have questions there. It's a very good idea to practice inserting and removing the diaphragm several times before you do decide to have sex to make sure you won't have any problems with it. It's also a good idea to put it in and leave it in for a while too, so you know what it feels like being in. Another option you have is the cervical cap, which is similar in principal to the diaphragm in that it's a piece of rubber that blocks sperm from accessing your cervix. To use this option you also have to get fit by a health professional. If you would like to read about diaphragms, cervical caps, or other barrier methods, click here. The diaphragm works by blocking the entrance to the cervix. This thus prevents sperm from being able to access your uterus, and thus they are unable to fertilize your egg and make you pregnant. It is also common practice for women to put spermicide on the inside of the diaphragm, so just in case any sperm get around the diaphragm, they are further blocked by the spermicide. The reason the diaphragm has to stay in place for 6-8 hours after sex is to make sure that the sperm left in your vagina can die before you take the diaphragm away. If you took it out early, the sperm left behind in your vagina could easily access your uterus and make you pregnant. The diaphragm can very easily be used in conjunction with condoms for further protection against pregnancy and STIs. Another option would be the contraceptive sponge. In the United States we only have the Today Sponge, which was just re-released on the market and is just starting to make its way to shelves. In Canada, you have had the sponge on the market for a while longer, and there are a few other brands available. The sponges are round, and usually made of polyurethane or a similar material. They have spermicides inside of them. They are placed over your cervix, and then they absorb sperm during sex. Click here to read how to use the Today Sponge (other sponges are used the same way). These are commonly used in conjunction with condoms to increase the protection against pregnancy. For this method you don't have to get a prescription, they are sold next to the condoms in drugstores.
Choosing a birth control method always involves a lot of research, and
unfortunately, it also often involves playing the guinea pig until you
find something that you like. I recommend finding a health
professional/gynecologist that you feel comfortable with and go over all
your ideas for birth control methods, and see if they have any input.
You may also try asking some friends, or even relatives what methods
they use or have used and hear their thoughts.
"How old do you have to be to walk into a clinic and get on birth control without having a parent knowing about it?" Each state (and country) has their own laws regarding teenage sexuality. You should call local clinic's or doctor's offices to ask them about your own state's laws and their own policies. You can also visit the Alan Guttmacher Institute's (a great resource for research on sexuality and reproduction) info on state policies regarding minor's access to birth control. This is really basic info, so you should still call local offices to find out details. As well as state laws, another concern for privacy is cost. Many young women have problems gathering the money to cover the office visit as well as the birth control itself, especially when they do not involve their parents. My advice would be to call around for the best prices for the office visit. You may want to call non-profit women's clinic's (like the Emma Goldman Clinic if you're around Iowa City) over private doctor's offices, because at the clinics the prices will most likely be lower. When you do get in for the exam, tell them that you are looking for inexpensive birth control, and then they will keep that in consideration while writing your prescription. Then make sure you call around to a lot of pharmacies for prices before getting it filled (prices can vary widely). It is important that you do not let your fears get in the way of you getting the health care you need. Even if you have to put off birth control for a while, it is still important that you get a gynecological examination once a year if you are sexually active. They can also answer any questions about sexuality that you may have. At these exams they will make sure that you are healthy by screening for cervical cancer (a common cancer for sexually active young women), and they can check you for sexually transmitted infections (STIs). STIs are very common among young people. Even if you start using birth control you still need to use condoms EVERY TIME that you have sex, because hormonal birth control (pill, patch, ring, Depo) provides no protection against STIs.
As for Janet's question, it is possible to start birth control before
you start having periods. It is possible to become pregnant even if
you have never had a period before. If you don't go on some kind of
birth control, or if it takes a while to start it, you need to be very
careful with condoms. You also need to watch your body very carefully
for pregnancy symptoms. Since you aren't having periods, it could be
possible for you to get to be very far along before you realize that you
are pregnant. It is also very important for you to get checked for STIs
while you are getting your exam. Not having periods does not make you
immune for STIs.
"If I become pregnant while on birth control pills, will it cause me to abort if I did not know I was pregnant and continued taking the pills?" Taking birth control pills does not cause an established pregnancy (meaning a positive pregnancy test and she is FOR SURE pregnant) to end. However, ideally you should quit taking your pills as soon as you find out that you are pregnant, because there is the possibility that continuing to take birth control pills (and any medication really) during pregnancy could cause birth defects. You shouldn't start taking birth control unless you are sure that you are not pregnant. This is one of the many reasons that women are told to start the pill with their period, because then at least they have a good idea that they are not pregnant. From reading the first question, it looks like it's been more than 3 weeks since this intercourse, and therefore, any pregnancy test will work right now. Take the test, and if it's positive, quit taking your birth control pills. Then you should call your health care provider to start finding out about your pregnancy options. I can't tell you exactly what the pill will do to your body, or a developing pregnancy. Pill manufacturers do tell people not to take them if they may be pregnant, because there is a risk for birth defects. You should talk to the person who prescribed you your pills to find out more specific information.
Whenever you find out that you are pregnant, you should see your health
care provider right away. If you are planning on continuing the
pregnancy, they can get you started on pre-natal care. They can also
answer your questions more specifically about what effects birth control
pills could potentially cause. If you do not want to continue the
pregnancy, or are not sure, you should start talking to people right
away. You need to make a decision regarding the pregnancy sooner, rather
than later, because the earlier you decide the more options you have.
Try visiting
www.pregnancyoptions.info. This website has very good,
non-judgmental information that has been very helpful to women facing an
unplanned pregnancy.
There's no health problems from not having a period every month (otherwise birth control methods like Seasonale and Depo Provera, where women have very few, if any, periods would be off the market). One of the big reasons that women want to regulate their periods, is that it is hard to tell when you will ovulate, and thus get pregnant, if you don't have regular, monthly periods. Yes, you can get pregnant if you only have 2 periods a year. But the problem, is that you could be up to 6 months or more along before you "miss a period". Obviously, that would be very bad. Some women who only have a few periods a year only ovulate a few times a year, but others ovulate more often than that. I can't tell which one you are, so you need to be careful with your birth control. You will most likely not have problems becoming pregnant in the future, except that, again, you may not be able to tell when you are ovulating (an easy solution, is when you want to become pregnant just have sex all the time, rather than just when you may be ovulating). If you are having sex at all you need to be using some kind of birth control (unless you want to get pregnant). If you are not comfortable taking hormonal birth control, you should go back to your doctor/physician and talk about your other options. You can do stick to using condoms every time. Sometime here in 2005 the birth control sponge will be available, and that is commonly used in conjunction with condoms to further decrease the risk of becoming pregnant. Click here if you want to read an article from our most recent newsletter about the sponge and its return to American shelves. You can also talk to your physician about other barrier methods such as diaphragms and cervical caps. To use those, your physician has to fit you for them, since they come in many different sizes, but they can be a good option for people who do not want to take hormones.
Whether or not you want to use hormonal birth control is entirely up to
you. If you feel more comfortable using barrier methods, then do that.
Just make sure that you use some kind of birth control method, unless
you want to become pregnant, because the fact that you don't have as
many periods as other women does not protect you from pregnancy.
"Do I have to get a physical exam before I get any form of birth control? If you would like to go on hormonal birth control (pill, patch, ring, Depo, and the hormonal IUD), you do have to have an annual exam. Along with a pap smear, a pelvic exam, and often a breast exam and urinalysis, this is most women's physical for the year so they often will check blood pressure and your breathing and heart rate. If you choose to have the copper IUD, it is generally recommended that you go in for an annual exam, because besides checking in on the other factors, they want to make sure the IUD is still placed correctly. If you want to get a diaphragm or cervical cap, you have to go to a physician to get fitted for those. They come in varying sizes, and for maximum effectiveness, you need one that fits you properly. It is generally recommended that you get annual exams with those methods as well, and bringing it in with you, so they can make sure it still fits properly. If you choose to use over-the-counter contraceptives such as condoms, spermicides, or the sponge, you technically don't have to get an annual exam, since you don't need a prescription for those birth control methods. However, it is a good idea to get annual exams every year, because the pap smear can be a life saving cancer screening. It's also good to check in with a physician on a regular basis, just to make sure you're doing ok.
At the Emma Goldman Clinic, our fees are on a sliding scale for all of
our services. We also have some special rates for teens and full-time
students. We accept insurance, and we are a preferred provider with Blue
Cross/Wellmark. If you would like to make an appointment with us, or
have any questions about our fees or services call us at 319-337-2111 or
toll-free at 1800-848-7684.
We looked up prednisone, and it doesn't affect hormonal birth control.
However, and a very big however, being on hormonal contraceptives can
increase the effectiveness of prednisone. You need to talk to you
physician and your pharmacist and tell them you are on hormonal birth
control. They may want to lessen your dose of the prednisone, to
decrease adverse effects and potential hazards. Anytime you are
prescribed any medication, you need to tell both your doctor and your
pharmacist what other medications you are on, including birth control.
There are a lot of medications that prevent birth control from working,
causing many women to become pregnant, and in this case there are
medications that can interact in potentially dangerous ways. If you have
already gotten this prescription, you need to call your pharmacist and
doctor right away to make sure you should still take it.
Antibiotics are known to decrease the effectiveness of birth control pills and almost all hormonal birth contol. We tell our clients that when they are on antibiotics (or other medications that reduce the effectiveness of birth control) that they need to use condoms for the whole time they are taking the medication, and for a full week after they stop. This is because being on these other medications can cause you to ovulate, and thus become pregnant. It's important to use condoms for the week afterwards to give any egg released enough time to leave your body without meeting any sperm. It's hard to tell from your question exactly when things happened. If this unprotected sex happened within the last 5 days, you can use emergency contraception (EC) to prevent pregnancy. Visit www.not-2-late.com to find out where you can find EC in your area.
If it's been more than 5 days, unfortunately all that's left to do is
take a pregnancy test. The strongest tests out on the market will need
it to have been at least 7-10 days since the unprotected sex to tell if
you are pregnant. Read the package before buying the test. Get one that
is labeled as being able to give results sooner (before your period).
Take the test using urine from the first time you pee in the morning.
This sample is the most concentrated, and will give you the most
accurate possible result. If the first test is negative, take another
one each week until you have a positive result or until you get a period
that is normal in length and flow compared to your other periods.
Unfortunately, some women get stuck playing the guinea pig, trying all
these different kinds of pills/kinds of birth control until they find
something that works. Also, unfortunately, some women will never find a
hormonal birth control method that works for them, and they have to use
non-hormonal methods. I would recommend that you go back to your
physician. Just because the first doctor was making you switch pills all
the time, that doesn't mean they're bad or anything (unless there was
something else going on). You're just unlucky that the first ones you
tried didn't work. I don't know what kinds you have tried so far, you
may want to try a progestin-only birth control, like Depo Provera, the
Mirena IUD, or the minipill. Sorry I can't give you more definitive
news.
"Does the birth control make you get your period even if you are
pregnant?"
An important fact to know about periods and pregnancy is that it isn't
necessarily a lack of pregnancy that causes women to bleed monthly, it's
a drop in hormones. Whether or not one is on hormonal birth control
(pill, patch, ring, Depo) it is possible to have bleeding during
pregnancy that occurs about the same time a period would normally
happen. This is especially common early in the pregnancy, but it can go
further. Usually this bleeding is lighter and shorter than normal
periods, but sometimes it can be so similar to normal periods that it is
hard to tell the difference. This is why any periods that are
lighter/shorter than normal, or that come at odd times should be a
reason to take a pregnancy test.
"What's the difference between the morning after pill and the abortion pill?" The "morning after pill" is also known by the name Emergency Contraception (EC). EC is a series of pills a woman takes as soon as possible, but up to 5 days, after unprotected sex, and it is very effective at preventing her from becoming pregnant. It won't end an established pregnancy; it is not an abortion. Right now EC is only available by prescription. Click here to learn more about EC.
The abortion pill, also known as RU-486, medical abortion, non-surgical
abortion, or by the brand name Mifeprex is a medication that women can
take after they are pregnant to end the pregnancy. It can't be taken
unless the woman has a positive pregnancy test and she is confirmed to
be pregnant, and less than 9 weeks from her last period. Mifeprex has to
be given by a doctor.
Click here to learn
more about Mifeprex and non-surgical abortions.
"Can you please explain to me why and how EC (emergency contraception) can work up to 5 days after sex, when the sperm has already entered the vagina?" "Is EC just as effective if a woman is on birth control compared to someone who is not? What else does EC do other than prevent ovulation?" One of the ways EC works, is if the woman hasn't ovulated yet that month, it puts off ovulation a few days, to let the sperm have a chance to die off before the egg is released. It also changes the cervical mucus in the vagina, making it harder for sperm to move. It also changes the uterine lining, making it thinner, so that if some sperm does make it to the egg, the fertilized egg is less likely to implant in the uterus. If the fertilized egg implants in the uterus, then the woman is pregnant, and EC will not do anything to the pregnancy. This all works better if the EC is taken closer to the unprotected sex, but it is effective at preventing pregnancy up to 5 days afterwards. Progestin-only ECs, like Plan B, which is the most commonly used EC in the United States, are 89% effective at preventing pregnancy if taken within 72 hours of unprotected sex. This means that if 100 women take EC only 1 will become pregnant (pregnancy/contraception statistics are a little screwy like that). The effectiveness of EC drops 2-3% between 72 and 120 hours (5 days) after the unprotected sex. It doesn't make a difference if the woman is also on any other birth control, EC is just as effective.
Click here if you would like to read some more detailed information
about EC. You can also ask your gynecologist or health
care provider.
"What are some of the reasons why EC (emergency contraception) wouldn't work?" EC, like any birth control method, has a failure rate. Just like how the pill sometimes fails, even when women take it perfectly, EC sometimes doesn't work, even if the woman took it just like she was supposed to. Plan B, the most common EC in the United States, is 89% effective at preventing pregnancy when taken up to 72 hours after unprotected sex (the effectiveness drops 2-3% between 3 and 5 days), which means that if 100 women took Plan B after unprotected sex, 1 would be come pregnant. If a woman does become pregnant after taking EC, it has not been shown to cause any harm to the pregnancy. If you would like to learn more about EC, click here.
To make sure that EC is as effective as possible, try to take it as soon
as possible after unprotected sex. It is effective up to 5 days
afterwards, but it is more effective if you take it sooner. It's a good
idea to find out where you can get EC, and how to get it, before you
need it. That way you won't be pushing that 5 day mark. If you're in the
Iowa City area, you can call us here at the clinic to learn more about
getting EC; our toll-free number is 1800-848-7684. You can also visit
www.not-2-late.com to find out where you can get EC in other parts
of the country.
You've got the basic idea down, let me just tell you how this works. First, not all birth control pills are approved for use as emergency contraceptive (EC, formerly known as the morning after pill). Click here to see the list of pills that have been approved for this use. This page is our page on EC, so you can also read all about how it works. For most of these you take 4 or 5 pills at a time, in two doses that are 12 hours apart. The reason you split up the pills into two doses, is it is common for these pills, since this makes a high dose of hormones, to make you a bit nauseous. Splitting up the dose helps reduce this feeling a lot. If you don't have those brands of birth control pills on hand, you can use Plan B. Plan B is a medication that is specifically packaged to be used as EC. You can find this at many reproductive health clinics, or at many pharmacies. It's a good idea to check out which pharmacies in your area carry EC before you need it, so you don't have to run all over town in that event. You can also visit www.not-2-late.com. They have a directory of physicians all around the country that prescribe and dispense EC.
Also, while EC is most effective the soonest that you take it, it is
still effective if you take it up to 5 days after sex, not just the
"morning after" (hence the change in the name).
"I took both Plan B
(emergency contraception, EC) pills at
once. 4 hours later I had sex with my boyfriend, but the condom broke.
We are just wondering, could I be pregnant since I just took Plan B
before this happened?" There haven't been studies about the effectiveness of taking emergency contraception (EC) before sex. These medications were intended to be taken in emergency situations, for instance, when the condom breaks, and not meant to be your regular birth control method. If you regularly have unprotected sex, or if you are planning on having unprotected sex, you should just get on a regular birth control method, for instance the pill, rather than relying on EC. EC isn't as effective as hormonal birth control taken regularly. EC is 89% effective, vs. the pill is 99.7% effective if taken correctly. 89% doesn't sound all that great, but in a case of the condom breaking, it is way more effective than doing nothing. EC wasn't meant to be used regularly. It's supposed to be a once in a while thing. Because of that, it hasn't been studied to see if it works well if you take it before sex, or if you take it several times within each month. EC is only approved for protecting against pregnancy for 1 sex act. So, with the second question, technically, you should take a second dose of EC. You should have a talk with your health care provider or the place you get your EC to see if they have their own opinion on this. Remember that hormonal birth control, including EC, provides no protection against sexually transmitted infections (STIs), and they don't make any kind of "morning after pill" for STIs. You should use condoms each time you have sex to protect yourself against STIs.
If you're having problems with condoms like this regularly, you should
either go over condom use to make sure you're using them correctly, or
you should consider another birth control method. Condoms are most
likely to break when they are the wrong size for the guy, or if they're
put on incorrectly. If you would like to see an illustration of how to
put on a condom,
you can click here. This goes to the Durex Condoms website, but if
you prefer other brands of condoms, the other companies usually have
this same information available on their websites. You and your
boyfriend should go over this well before you have sex, so you aren't
trying to figure it out in the heat of the moment. It's probably also a
good idea to use more lubricant during sex. If you get too dry, then
that can cause more friction, which can thus cause the condom to break.
"I had unprotected sex on Saturday night.
The guy came inside of me, but he said he didn't get fully aroused, so
it was just a little. I'm supposed to start my period tomorrow (8/17). I
took EC (4 Lo/Ovral pills), so that hopefully I wouldn't get pregnant.
What are my chances?"
"I had unprotected sex. My friend gave me
5 Lo/Ovral pills, because that's all she had. She said that the rest of
the pills are pink, and those ones are for your period time. If I took
the pink pills too, could they be effective? With that first question, I feel like I should comment about your boyfriend saying he wasn't fully aroused, and so it was "just a little". Remember, that "just a little" is enough to get pregnant (hence, withdrawal not working). Also, if his penis was erect enough to go inside of your vagina, that's aroused. After that, Please start by clicking on this link. This is our info on Emergency Contraception (EC), and at the bottom of the page it says how to go about making EC out of normal birth control pills. EC is always 2 doses of hormones that you take twelve hours apart. If you are using Lo/Ovral you take 4 white pills at each of those doses (so you take a total of 8 pills). EC only has it's top effectiveness if you take both doses. You also have to take the correct color of pills that it says on the chart. Period week pills, do not have any hormones in them, so no, it will not be effective to take them. If you are still within 5 days of unprotected sex, you can do another run of EC to prevent pregnancy. If you live in the Iowa City area, you can come here to the Emma Goldman Clinic to pick up Plan B. Plan B is the brand name for pre-packaged EC, so there you only have to take 2 pills (12 hours apart). If you don't live around Iowa City, you can visit www.not-2-late.com to find places in your area where you can get EC. Renae from the first question has the other option of waiting to see if she gets her period. Taking EC (even a half dose) generally messes with women's periods. Your period could come a little early or late, it could be heavy or light. But if you don't get a period at all within 3 weeks of taking EC, you should take a pregnancy test. It would also be a good idea if this period is super light.
The other thing you should do in the future is to make your boyfriend
wear a condom no matter what. Boys who won't wear condoms aren't worth
sleeping with. You deserve better than this level of stress.
Prices from pharmacy to pharmacy, and clinic to clinic can vary widely. To find out how much EC costs, you should call the pharmacy or clinic that you will go to. Here at the Emma
Goldman Clinic we have competitive prices and a sliding scale for all of
our fees. Please call the clinic with all questions about our prices.
Our number is 319-337-2111 or toll-free at 1800-848-7684.
"How do I get EC within 5 days if I live
in the US?"
Currently, emergency contraception (EC) is a prescription medication in
the United States, so you have to get a prescription to get it.
Emergency contraception is very good at preventing pregnancy if you
take it up to 5 days after unprotected sex, but it's more effective the
sooner you take it. You may try calling your gynecologist, but
sometimes, even your general doctor will help you get it. Many doctor's
won't require a visit for this if you've been seen by them before; they
can just call the prescription into a pharmacy. We provide EC to women
here in our clinic, but you probably don't want to drive all the way
here from Missouri. (Anyone in the Iowa City area, or who really likes
driving, can call us toll-free at 1800-848-7684 to find out how you can
get EC from us.) Another option is to visit
www.not-2-late.com. There you can look up doctors and offices in
your local area that provide EC.
"I took the emergency pills a week ago, and now I am bleeding. Why?"
Emergency Contraception (EC) is a pretty large dose of hormones, and
taking them can cause you to have some bleeding or your next period to
be a little funny. This is totally normal. Just watch when you get your
next period to make sure that it's as long and heavy as all your other
periods. If it's lighter/shorter than normal, or if you don't get it at
all, you need to take a pregnancy test.
"Emma, can the morning after pill (emergency contraception) cause your period to be late?"
Emergency contraception (EC), also known as the "morning after pill",
can commonly make the next period after taking it a bit funny, whether
or not you are on any other kind of birth control. The next period could
come early, or late, it could also be heavier or lighter. If you don't
have any period at all within 3 weeks after taking EC, you should take a
pregnancy test. For the most accurate test, take it with urine from the
first time you pee in the morning.
If you would like to learn more about EC, click here.
That would probably be a very good idea. We tell our clients that if
they miss a pill, they need to use condoms for a full week after
they are caught back up. Missing just that one pill can trigger
ovulation, and you can become pregnant. You have up to 5 days after the
unprotected sex to take EC (emergency contraception, which can prevent
pregnancy after unprotected sex), but it's better to take it as soon as
possible. If you are in the Iowa City area, you can come here to the
Emma Goldman Clinic to get EC. If you live elsewhere, check out
www.not-2-late.com, and they can refer you to local places to get
EC.
Accidental use of Emergency
Contraception (EC or Plan B) has not been linked to increased risk of
birth defects. Women on birth control who don't immediately realize
they're pregnant can and have been able to carry healthy pregnancies to
term. Studies have specifically confirmed that babies born to women who
were initially on birth control pills during pregnancy do not have
higher rates of birth defects. This is why several years ago, the U.S.
Food and Drug Administration had warnings about the possibility of harm
to the fetus removed from manufacturer labels on birth control pills.
However, it is true that there haven't been specific studies on the
effects from the higher dose of birth control hormones contained in EC.
Questions about Condoms "Are "dollar store" condoms safe?" On the whole, most condoms sold in the United States are safe. The ones specifically to watch out for are ones sold for "novelty purposes". These aren't necessarily tested for contraceptive or protective purposes. Beware of ones in vending machines, since those occasionally will be well past the expiration date by the time you buy one. Also, it's not a good idea to buy any that are stored in a place that has dramatically varying temperatures, for instance, gas station bathrooms that aren't insulated for weather. Once you have your condoms at home, you need to care for them properly to ensure they keep their maximum effectiveness.
When choosing condoms, make sure you are buying the right kind for you. Men rarely need the "maximum" or extra-large sized condoms. Buying condoms that are larger than your penis means they will fall off more often. Also, there is no reason to use condoms lubricated with spermicides. Having spermicide on the condom does not improve the effectiveness, and the chemical spermicides can be very irritating to the vagina or the rectum. A good place to go for inexpensive and safe condoms (and other contraceptives) is your local women's or reproductive health clinic. Here at the Emma Goldman Clinic for instance, we sell condoms at 8 for $1.
If you want a good research for determining whether your chosen brand of
condoms is safe, you should check out Consumer Reports. They are a
non-profit organization that evaluates basically everything that you can
buy in the United States, and in February of 2005, they tested 23
different kinds of latex condoms. Visit
www.ConsumerReports.org, and put "condoms" into their search box.
Condoms are rated at 97-98% effective, because even when used perfectly, they sometimes do fail. This is just like any other birth control method. Sometimes women become pregnant even when they take the pill/patch/ring/Depo exactly like they were supposed to. The 2-3% failure rate on condoms are attributed to condoms breaking or falling off (which they occasionally do even when put on and used correctly), manufacturing defects or problems, or some problem with the condom after it left the factory that could be caused by things like temperature changes, for instance. Failures can be caused by a lot of things. Remember, that failures are not exclusive to condoms. No birth control method (except for complete abstinence) is 100% effective at preventing pregnancy.
The best thing that you can do is to make sure you are prepared for when
the condom breaks or falls off. Make sure you know where you can get
emergency contraception (EC).
Click here if you would like to learn more about EC. EC prevents
pregnancy even after the condom break, but it is most effective the
sooner that you take it. At our clinic we allow women to buy extra EC
that they can keep at home just in case. Maybe your doctor will let you
do that too, or at least they may be willing to call you in a
prescription or something. If your doctor won't prescribe EC for some
reason, try visiting
www.not-2-late.com, which will tell you about other places you can
get EC in your area.
“Are
condoms reliable when preventing pregnancy? I'm not on the pill and my
lover and I have only being using condoms as a means of pregnancy
prevention. One little problem is this month my period is late. Can
condoms break or leak?”
Yes, it is possible for condoms to both leak and break. The most common cause of breakage/leakage is improper use. It is important to make sure that the guy is using a size of condom that is appropriate for him. A lot of guys like going into the store and buying the “maximum” size condoms, but very few need that extra room. If a smaller guy puts on a gigantic condom, it will leak and fall off. As for breakage, that is commonly caused by the condom not being put on correctly. It is very important to pinch off a bit at the end of the condom. This makes it so there’s no bubbles of air in the condom, which will cause it to break, and it also leaves some space at the end for the semen to go. No space at the end will cause the condom to break when he comes. If you would like to see an illustration of how to put on a condom, you can click here. This goes to the Durex Condoms website, but if you prefer other brands of condoms, the other companies usually have this same information available.
If your period is late, you should take a pregnancy test.
"My boyfriend and I had sex for the first
time a couple of nights ago. We got kinda into it, but we stopped and
the condom fell off inside of me. He didn't come yet. Could I still be
at risk of being pregnant?" Having a condom in the vagina doesn't cause any immediate problems unless it is left for a significant period of time. Sometimes the condom will come out on its own, but often it takes more for it to come out. The vagina is only a few inches deep, so it's not usually too hard to find things like that. The woman should just stick her finger in her vagina and try to pull it out. If it doesn't come out, or if she can't find it, she can go in to her gynecologist and they can remove it for her. She should definitely try to find it herself first to avoid the office visit fee. The other concerns about the condom falling off are pregnancy and sexually transmitted infections (STIs).
If the condom fell off during sex, even before he ejaculated, you can
become pregnant. This is because even before the guy ejaculates (cums,
comes) his body will often produce what is commonly called "pre-cum".
This is a fluid that comes out of the penis before ejaculation that has
sperm in it. Pre-cum doesn't have the same concentration of sperm that
cum has, but women do often still become pregnant from it. This is why
many women become pregnant from the condom breaking or falling off. If
this has been within the last 5 days, you can still take emergency
contraception (EC) to prevent pregnancy. If you would like to find out
where you can get EC in your area, visit
www.not-2-late.com.
"I have pimple-like pimples inside my vagina. Could it be caused from using a condom?" Anytime you have sores in or around your vagina, or genital area, you should take them to a physician/gynecologist right away. If you let them heal over before going in, they will not be able to diagnose them. People occasionally have allergic reactions to latex condoms, but "pimple-like pimples" could also very easily be symptoms of a sexually transmitted infection (STI).
We recently posted a question about what to do if you are allergic to
latex,
click here to read about how you can still have safer sex with a latex
allergy.
"I'm allergic to latex. What
other options do I have condom-wise?" There are condoms made of
polyurethane that are considered effective for preventing pregnancy and
STI transmission (including HIV). Some people even the thinner material
of polyurethane to enhance pleasure. If someone is not allergic to
latex, the FDA and other organizations do strongly recommend the use of
latex condoms as they are slightly less likely than polyurethane condoms
to break or come off during sex. However, consistent and proper use of
either condom type provides effective contraception and STI prevention.
Learning how to put on condoms properly, along with the use of
lubricant, helps with keeping condom use effective.
Questions about Birth Control Pills The answer is yes. Anytime you are late by more than 6 hours taking your pill, you can become pregnant. Also, he 6 hour window may not apply to all types of pills - some pills may have a shorter window to be late (ie low dose pills). We tell our clients that if they miss a pill or are late more than the allowed number of hours for their pills, they need to use a back-up method (like condoms) for one full week after they are all caught up. If you have unprotected sex within that week you are running a large risk of becoming pregnant. If you have had sex after missing or being late for a pill, you can still use Emergency Contraception (EC) to prevent pregnancy. If you take EC up to 5 days after the unprotected sex it is very effective at preventing a pregnancy from occurring. If you would like to read more about EC, click here. If you have further
questions about how to take your birth control pills correctly, you
should contact the health care provider that prescribed or gave you the
pills.
YES! Birth control pills don't work until AFTER you take them. Depending on when in her menstrual cycle she started taking her pills, they wouldn't have become effective until 1-2 weeks after starting the pills. If she did become pregnant from that sex act, the birth control pills also wouldn't do anything to disrupt or end that pregnancy.
If it's been at least 10 days since the
unprotected sex, she can try taking a pregnancy test. Make sure she
takes it using urine from the first time she pees in the morning. That
urine sample will be very concentrated, and it will give her the most
accurate results.
"If someone was late taking a pill (more than 6 hours), how soon could they ovulate?" It's very hard to predict exactly when someone will ovulate. We tell our clients, that if they are more than 6 hours late taking their pill, they should take it as soon as they remember, then use a back-up method of birth control, like condoms, for a full 7 days afterwards. This is because a woman could ovulate immediately after that 6 hours, but maybe not for a couple days. She could also not ovulate at all in this instance, but most women would much rather be safe than sorry. The 6 hour window for pills really only applies to individual occurrences. You need to take the pill at the same time every day, and only use that 6 hour window occasionally, if ever. If you fluctuate in your pill times like that, between 2 and 7, your dose of hormones your body is getting won't be constant, and the pill might not work to its maximum effectiveness. If you ever vary outside of the 6 hour window, remember to use a back-up method of birth control, like condoms, for 7 days after you are caught up on your pills. It's a good idea to always use a condom, even if you take your birth control pills perfectly, to provide protection against sexually transmitted infections (STIs).
If you had unprotected sex after missing a pill, you still have 5 days
to prevent pregnancy.
To learn more about emergency contraception, click here.
Missed pills are the main cause of irregular cycles. We do not recommend
that our clients stop in the middle of a cycle to start a new
pack.
If you miss a pill in the future, take it ASAP and then use a backup
method (ie condoms)
for 7 days afterward.
If you are concerned about being pregnant, a high-sensitivity
pregnancy test will be positive 10 days after unprotected intercourse.
If it’s negative, you can either wait until your period starts and use a
backup method until then or begin a new pill pack and use a backup
method for two weeks.
No, as long as birth control pills is the only medication you are
taking, you shouldn't get a positive pregnancy test unless you are
actually pregnant. Seasonale, and hormonal birth control generally, is
made of artificial versions of the hormones progesterone and estrogen.
Pregnancy tests test for the hormone called human chorionic gondotropin
(hCG) which is only present during pregnancy and soon after the
pregnancy ends. Therefore, the hormones from birth control don't affect
pregnancy tests.
Just go ahead and change the time you take the pill. Since you are
making a switch bigger than 6 hours (I'm on the assumption that you are
switching from 8am), you should probably be on the safe side and use a
back-up method, like condoms, for a full week after the switch. It's a
possibility that you could have breakthrough bleeding if you make a big
switch like this, so if you do, just make sure you use a back-up method
for the entire time you bleed, and for a full week after you stop. That's something that will vary woman to woman, no matter how long they were on the pill. The pill only stays in your body for 24 hours. Some women take a few months for their cycles to get back to normal post-hormones. Some women take a few months to get pregnant after stopping the pills, while there are lots of other women who become pregnant after just missing one pill.
The big thing is that post-pills women can ovulate at ANY time, so it's
important to use a back-up method, like condoms, unless you want to
become pregnant.
"My birth control pills are 3 different
colors. What does that mean?"
That means that you have a triphasic (3 phases) pill. Each color of pill
has a slightly different level of the birth control hormones. Having
these different levels over the course of the month is supposed to more
closely mimic your body's natural hormones. Triphasic birth control
pills are just as effective as pills that give you a constant level of
hormones throughout the cycle (monophasic pills).
All doses of birth control pills are rated at the same effectiveness
(99.7% if taken correctly). As long as you take it at the same time
every day, and don't have any breakthrough bleeding, then you are
protected. If you are having side effects such as, but not limited to
breakthrough bleeding, or if you are especially worried about being on a
low dose, you should speak with the person who prescribed your pills.
When you are seeing your health care practitioners, it is very important
that you speak up about any concerns that you have.
"I'm on
[a brand of birth control pills] and I
get them from my doctor. He doesn't have any left, so he said I can take
another pill. Will that do anything different?" Ortho Tri-Cyclen Lo is similar to Ortho Tri-Cyclen, but it's a lower dose of hormones. Most pills really have the same hormones in them, just in different doses. Since they are the same basic ingredients, a lot of women do OK when switching between one pill and the other. However, may be switching the dose that you get in each pill, you may have some side effects. The most common, is to have breakthrough bleeding (bleeding that comes at a time other than your period week). If you have this, use condoms for the whole time you are bleeding and |
