Pregnancy can be a very emotional time in your life. If your pregnancy is unexpected, you may be feeling scared or confused about what to do. It is important to remember that you have options. But first, you need to make sure that you're pregnant.
How do I find out if I am pregnant?
Take a pregnancy test. There are 2 kinds:
Urine test: These tests are also called home pregnancy tests. You can buy them at most drug stores, grocery stores and discount stores. Most home pregnancy tests can tell if you are pregnant about the time you would expect to get your period. The test is typically very accurate if done correctly.
Blood test: This test is done at your doctor's office or at a health clinic. It can tell if you are pregnant about a week before you would expect to get your period. This test is very accurate.
If you take a home pregnancy test and the result is positive, you should see your doctor to confirm the results. Your doctor will likely do a confirming blood test or urine pregnancy test and a pelvic exam to check the size and shape of your uterus (womb). This will help the doctor determine how far along you are in your pregnancy.
I'm pregnant. What choices do I have?
Deciding what to do about an unexpected pregnancy can be very difficult. There is a lot to think about. You have to make the decision that is right for you. Consider your personal situation and your beliefs. You have several options:
You can continue the pregnancy and raise the baby, even if you will be a single parent.
You can continue the pregnancy and create an adoption plan to allow someone else to raise the child.
You can end the pregnancy.
How do I make a decision?
It can be very difficult to decide what to do. It helps to talk to someone you trust. This can be your baby's father, a family member or a friend. Your doctor, minister or rabbi may also be helpful. Try to find someone who won't pressure you into making a decision you are uncomfortable with. If you don't feel like you have anyone you can talk to, your doctor may be able to help you find a specially trained counselor.
Before you make any decision, you should learn about each of your options. Getting more information can help you make your decision. It can also help you feel more sure about your decision.
How soon do I need to make a decision?
If you are thinking about ending the pregnancy, it's best to try to decide as soon as possible. There are fewer risks associated with early abortions.
While you are making your decision, be sure to take good care of yourself.
Don't drink alcohol.
Don't smoke.
Don't do drugs.
Eat healthy.
Don't take any medicines without first talking to your doctor.
Get plenty of rest.
Exercise.
If you are thinking about continuing the pregnancy, you should schedule an appointment with your doctor. Seeing your doctor regularly while you are pregnant will help make sure that you and your baby will be as healthy as possible.
Wednesday, March 16, 2011
Birth Control Options
What is contraception?
Contraception means preventing pregnancy, also called birth control. Most people know about options such as birth control pills and condoms. However, there are also other options. If you're thinking about birth control, talk with your family doctor. Your choice will depend on your health, your desire for protection against disease and your personal beliefs and preferences. As always, when looking at birth control, keep in mind that any method only works if you use it consistently and correctly.
What kind of birth control is right for me?
The type of birth control you choose depends on your needs. Some people only need to prevent pregnancy. Other people may also want to protect themselves or their partners from diseases that can be passed by having sex. These diseases are called sexually transmitted infections (STIs). Some STIs include acquired immunodeficiency syndrome (AIDS), chlamydia, human papillomavirus (HPV), herpes, genital warts and syphilis.
Talk with your family doctor about the pros and cons of each birth control option.
Is saying "no" to sex really an option?
Yes. No method of birth control is 100% effective. The risk of getting pregnant or catching an STI may outweigh the pleasure you get from sex. The only way to make absolutely sure you don't get pregnant, get someone pregnant or get an STI is not to have sex at all.
Barrier methods of birth control
Barrier methods prevent pregnancy by blocking sperm from getting into the uterus. They include the diaphragm, the cervical cap, contraceptive sponges and condoms. Barrier methods must be used every time you have sex.
A woman must visit her doctor to be fitted for a diaphragm or a cervical cap. Using a diaphragm, cervical cap or contraceptive sponge may increase the risk of urinary tract infections in some women. Some women have allergic reactions with these methods.
Are condoms a good choice?
Yes. Condoms aren't expensive and are widely available. Condoms can be combined with other methods of birth control. Condoms are an especially good choice if you or your partner are also having sex with other people or if either of you have had sex with other people in the past.
Of all the barrier method options, condoms offer the most protection against STIs. Using a spermicide with condoms can offer better protection against pregnancy, but it may not increase your protection against STIs. Spermicides containing nonoxynol-9 can cause genital irritation and may actually increase your risk of catching an STI.
Female condoms aren't as effective as male condoms, but they may be a good choice if a man won't use a male condom.
Hormonal methods of birth control
Hormonal methods of birth control prevent pregnancy mainly by preventing ovulation (the release of an egg by the ovaries). They do this by releasing the hormones estrogen and progestin (or progestin alone) into your body. Hormonal methods of birth control are prescribed by your doctor and include the birth control pill, the patch, the vaginal ring, hormone shots and implants and a type of intrauterine device.
What about the pill?
The birth control pill is an oral contraceptive, meaning you take it by mouth. For the pill to work, you have to take it every day. Most women who take the pill have a period every 4 weeks (1 a month). One type of birth control pill reduces the number of periods from 1 period a month to about 1 period every 3 months.
Some common side effects of birth control pills are nausea, headaches, acne, increased blood pressure, breast tenderness, bloating, weight gain and depression. However, not every woman who takes the pill will have side effects. You may have to try several types of birth control pills before you find the type that is best for you. The pill may reduce cramping and shorten the number of days of bleeding during the menstrual period. The pill may also help premenstrual syndrome (PMS). Women who take the pill should not smoke. Smoking increases the risk of serious side effects, such as blood clots.
What about the patch?
The contraceptive patch is a thin, flexible patch that you put on your upper arm, buttocks, stomach or chest (but not on your breasts). You put on a patch once a week for 3 weeks. On the 4th week, you don't wear a patch and your period starts.
The side effects are similar to those of birth control pills. Breast discomfort is more common in the first two months using the patch. The area of skin where the patch was placed can become irritated. Women who use the patch should not smoke. Smoking increases the risk of serious side effects, such as blood clots.
What is the vaginal contraceptive ring?
The vaginal contraceptive ring is a thin, circular, flexible ring that you insert into your vagina. After you insert the ring, you leave it in your vagina for 3 weeks and then take it out. It doesn't have to be in a specific position in your vagina. During the week the ring is out, your period starts. After a week without the ring, you put in a new one.
If the ring is out of your vagina for more than 3 hours, it may not work effectively when you put it back in. To protect against pregnancy, you will need to use another form of birth control until the ring has been in all the time for 7 days in a row. Some women stop using the ring because of concerns such as feeling the ring in their vagina, problems with sex and the vagina pushing out the ring. Women who use the vaginal ring should not smoke. Smoking increases the risk of serious side effects, such as blood clots.
What about hormone shots and implants?
The hormone shot is an injection (typically in your arm). You have to visit your doctor for each shot. One shot prevents pregnancy for 3 months. Women who have the shots may have some side effects, such as headaches and changes in their periods, moods and weight.
The hormone implant is a thin, flexible piece of plastic that is about the size of a matchstick. Your doctor inserts the implant under the skin of your upper arm. One implant prevents pregnancy for up to 3 years, but your doctor can remove the implant at any time. Side effects of the implant include irregular bleeding or spotting, or periods that are lighter or heavier than normal. Some women stop having periods entirely.
What about an IUD?
"IUD" stands for "intrauterine device." An IUD is a small, T-shaped device put in a woman's uterus by her doctor. Two kinds of IUDs are available. One contains copper and the other releases a small amount of the hormone progestin. The copper IUD has been in use for a longer period of time. It lasts for up to 12 years. The hormonal IUD is similar in size and shape to the copper-containing IUD, but it is safer and has fewer side effects. It lasts for 5 years.
To have an IUD inserted, you go to the doctor for a pelvic exam within a week after you start your period. After cleaning your vagina and cervix, the doctor slides a thin plastic tube containing the device into your uterus. Your doctor removes the plastic tube and makes sure that the IUD is in the right place. The IUD has strings that the doctor cuts to the right length. You have to check these threads each month to make sure that the IUD is in place. Some women find that their uterus pushes out the IUD. There is a risk of ectopic pregnancy (when a fertilized egg grows outside the uterus). There is also a risk of pelvic inflammatory disease, but the risk is lower than for traditional IUDs.
Some IUDs used in the past were related to serious health problems. Today IUDs are safer, but they still have some risks. Most doctors prefer to use IUDs only in women who have already had a baby. Side effects of all IUDs include cramping or pain when the IUD is first inserted and spotting between periods for the first 3 to 6 months. Side effects of copper IUDs include heavier bleeding and stronger cramps during periods. Side effects of the hormonal IUD include irregular periods in the first 3 to 6 months. Some women stop having periods entirely.
Sterilization
Sterilization is when a man or woman has a surgical operation to permanently prevent pregnancy. If you're sure that you don't want to have children or you don't want more children, sterilization may be the right choice for you.
Tubal ligation (also called "getting your tubes tied") involves closing off a woman's fallopian tubes so eggs can't travel through them to reach the uterus. Your doctor can also close off your fallopian tubes by inserting a metal coil into each tube.
Men are sterilized with a vasectomy. During this procedure, the doctor closes off the man's vas deferens (sperm ducts) so sperm can't get through.
Natural family planning
Natural family planning requires a couple to learn when in the woman's cycle she can get pregnant (usually 4 days before and 2 days after ovulation). To prevent pregnancy, the couple must use a barrier method of birth control or not have intercourse during those days. There are a number of ways to keep track of a woman's ovulation. All of them require a lot of planning and commitment.
Is withdrawal effective?
No. When a man tries to pull out before ejaculating ("coming"), he usually leaves behind a small amount of fluid that leaks from the penis during sex. This fluid has enough sperm in it to cause pregnancy.
How well do these birth control methods work?
The box below shows the failure rates (number of pregnancies per 100 women per year) for different types of birth control. These numbers are for couples who use the methods the correct way every time they have sex. The failure rates are higher if you don't use birth control the correct way every time.
Failure rates for birth control methods when used correctly
(Number of pregnancies per 100 women per year)
Male condom alone 11
Female condom alone 21
Diaphragm with spermicide 17
Cervical cap with spermicide 17 to 23
Sponge with spermicide 14 to 28
Spermicide alone 20 to 50
Oral contraceptives 1 to 2
Contraceptive patch* 1 to 2
Vaginal contraceptive ring 1 to 2
Hormone shots less than 1
IUD less than 1
Periodic abstinence 20
Surgical sterilization (female) less than 1
Surgical sterilization (male) less than 1
Contraceptive patch is less effective in women who weigh more than 198 pounds.
Contraception means preventing pregnancy, also called birth control. Most people know about options such as birth control pills and condoms. However, there are also other options. If you're thinking about birth control, talk with your family doctor. Your choice will depend on your health, your desire for protection against disease and your personal beliefs and preferences. As always, when looking at birth control, keep in mind that any method only works if you use it consistently and correctly.
What kind of birth control is right for me?
The type of birth control you choose depends on your needs. Some people only need to prevent pregnancy. Other people may also want to protect themselves or their partners from diseases that can be passed by having sex. These diseases are called sexually transmitted infections (STIs). Some STIs include acquired immunodeficiency syndrome (AIDS), chlamydia, human papillomavirus (HPV), herpes, genital warts and syphilis.
Talk with your family doctor about the pros and cons of each birth control option.
Is saying "no" to sex really an option?
Yes. No method of birth control is 100% effective. The risk of getting pregnant or catching an STI may outweigh the pleasure you get from sex. The only way to make absolutely sure you don't get pregnant, get someone pregnant or get an STI is not to have sex at all.
Barrier methods of birth control
Barrier methods prevent pregnancy by blocking sperm from getting into the uterus. They include the diaphragm, the cervical cap, contraceptive sponges and condoms. Barrier methods must be used every time you have sex.
A woman must visit her doctor to be fitted for a diaphragm or a cervical cap. Using a diaphragm, cervical cap or contraceptive sponge may increase the risk of urinary tract infections in some women. Some women have allergic reactions with these methods.
Are condoms a good choice?
Yes. Condoms aren't expensive and are widely available. Condoms can be combined with other methods of birth control. Condoms are an especially good choice if you or your partner are also having sex with other people or if either of you have had sex with other people in the past.
Of all the barrier method options, condoms offer the most protection against STIs. Using a spermicide with condoms can offer better protection against pregnancy, but it may not increase your protection against STIs. Spermicides containing nonoxynol-9 can cause genital irritation and may actually increase your risk of catching an STI.
Female condoms aren't as effective as male condoms, but they may be a good choice if a man won't use a male condom.
Hormonal methods of birth control
Hormonal methods of birth control prevent pregnancy mainly by preventing ovulation (the release of an egg by the ovaries). They do this by releasing the hormones estrogen and progestin (or progestin alone) into your body. Hormonal methods of birth control are prescribed by your doctor and include the birth control pill, the patch, the vaginal ring, hormone shots and implants and a type of intrauterine device.
What about the pill?
The birth control pill is an oral contraceptive, meaning you take it by mouth. For the pill to work, you have to take it every day. Most women who take the pill have a period every 4 weeks (1 a month). One type of birth control pill reduces the number of periods from 1 period a month to about 1 period every 3 months.
Some common side effects of birth control pills are nausea, headaches, acne, increased blood pressure, breast tenderness, bloating, weight gain and depression. However, not every woman who takes the pill will have side effects. You may have to try several types of birth control pills before you find the type that is best for you. The pill may reduce cramping and shorten the number of days of bleeding during the menstrual period. The pill may also help premenstrual syndrome (PMS). Women who take the pill should not smoke. Smoking increases the risk of serious side effects, such as blood clots.
What about the patch?
The contraceptive patch is a thin, flexible patch that you put on your upper arm, buttocks, stomach or chest (but not on your breasts). You put on a patch once a week for 3 weeks. On the 4th week, you don't wear a patch and your period starts.
The side effects are similar to those of birth control pills. Breast discomfort is more common in the first two months using the patch. The area of skin where the patch was placed can become irritated. Women who use the patch should not smoke. Smoking increases the risk of serious side effects, such as blood clots.
What is the vaginal contraceptive ring?
The vaginal contraceptive ring is a thin, circular, flexible ring that you insert into your vagina. After you insert the ring, you leave it in your vagina for 3 weeks and then take it out. It doesn't have to be in a specific position in your vagina. During the week the ring is out, your period starts. After a week without the ring, you put in a new one.
If the ring is out of your vagina for more than 3 hours, it may not work effectively when you put it back in. To protect against pregnancy, you will need to use another form of birth control until the ring has been in all the time for 7 days in a row. Some women stop using the ring because of concerns such as feeling the ring in their vagina, problems with sex and the vagina pushing out the ring. Women who use the vaginal ring should not smoke. Smoking increases the risk of serious side effects, such as blood clots.
What about hormone shots and implants?
The hormone shot is an injection (typically in your arm). You have to visit your doctor for each shot. One shot prevents pregnancy for 3 months. Women who have the shots may have some side effects, such as headaches and changes in their periods, moods and weight.
The hormone implant is a thin, flexible piece of plastic that is about the size of a matchstick. Your doctor inserts the implant under the skin of your upper arm. One implant prevents pregnancy for up to 3 years, but your doctor can remove the implant at any time. Side effects of the implant include irregular bleeding or spotting, or periods that are lighter or heavier than normal. Some women stop having periods entirely.
What about an IUD?
"IUD" stands for "intrauterine device." An IUD is a small, T-shaped device put in a woman's uterus by her doctor. Two kinds of IUDs are available. One contains copper and the other releases a small amount of the hormone progestin. The copper IUD has been in use for a longer period of time. It lasts for up to 12 years. The hormonal IUD is similar in size and shape to the copper-containing IUD, but it is safer and has fewer side effects. It lasts for 5 years.
To have an IUD inserted, you go to the doctor for a pelvic exam within a week after you start your period. After cleaning your vagina and cervix, the doctor slides a thin plastic tube containing the device into your uterus. Your doctor removes the plastic tube and makes sure that the IUD is in the right place. The IUD has strings that the doctor cuts to the right length. You have to check these threads each month to make sure that the IUD is in place. Some women find that their uterus pushes out the IUD. There is a risk of ectopic pregnancy (when a fertilized egg grows outside the uterus). There is also a risk of pelvic inflammatory disease, but the risk is lower than for traditional IUDs.
Some IUDs used in the past were related to serious health problems. Today IUDs are safer, but they still have some risks. Most doctors prefer to use IUDs only in women who have already had a baby. Side effects of all IUDs include cramping or pain when the IUD is first inserted and spotting between periods for the first 3 to 6 months. Side effects of copper IUDs include heavier bleeding and stronger cramps during periods. Side effects of the hormonal IUD include irregular periods in the first 3 to 6 months. Some women stop having periods entirely.
Sterilization
Sterilization is when a man or woman has a surgical operation to permanently prevent pregnancy. If you're sure that you don't want to have children or you don't want more children, sterilization may be the right choice for you.
Tubal ligation (also called "getting your tubes tied") involves closing off a woman's fallopian tubes so eggs can't travel through them to reach the uterus. Your doctor can also close off your fallopian tubes by inserting a metal coil into each tube.
Men are sterilized with a vasectomy. During this procedure, the doctor closes off the man's vas deferens (sperm ducts) so sperm can't get through.
Natural family planning
Natural family planning requires a couple to learn when in the woman's cycle she can get pregnant (usually 4 days before and 2 days after ovulation). To prevent pregnancy, the couple must use a barrier method of birth control or not have intercourse during those days. There are a number of ways to keep track of a woman's ovulation. All of them require a lot of planning and commitment.
Is withdrawal effective?
No. When a man tries to pull out before ejaculating ("coming"), he usually leaves behind a small amount of fluid that leaks from the penis during sex. This fluid has enough sperm in it to cause pregnancy.
How well do these birth control methods work?
The box below shows the failure rates (number of pregnancies per 100 women per year) for different types of birth control. These numbers are for couples who use the methods the correct way every time they have sex. The failure rates are higher if you don't use birth control the correct way every time.
Failure rates for birth control methods when used correctly
(Number of pregnancies per 100 women per year)
Male condom alone 11
Female condom alone 21
Diaphragm with spermicide 17
Cervical cap with spermicide 17 to 23
Sponge with spermicide 14 to 28
Spermicide alone 20 to 50
Oral contraceptives 1 to 2
Contraceptive patch* 1 to 2
Vaginal contraceptive ring 1 to 2
Hormone shots less than 1
IUD less than 1
Periodic abstinence 20
Surgical sterilization (female) less than 1
Surgical sterilization (male) less than 1
Contraceptive patch is less effective in women who weigh more than 198 pounds.
Birth Control: How to Use Your Diaphragm
The diaphragm is a dome-shaped cup that fits over the opening to the cervix and prevents pregnancy.
For effective birth control, your diaphragm (see pictures below) has to fit well. Your doctor will measure your vagina to find the correct size and fit for you.
Your doctor or a nurse will teach you how to put the diaphragm in and take it out. You also should read the directions from the company that made your diaphragm.
To be sure that you know how to use your diaphragm, you will need to practice putting it in and taking it out while you are in your doctor's office. Your doctor will check to see that the diaphragm fits right.
To lower your risk of getting pregnant, you must use your diaphragm correctly and use it every time you have sex. You must also use the diaphragm with spermicide (a gel or cream that kills sperm trying to enter the cervix) in order to prevent pregnancy. You can put the diaphragm in your vagina up to 1 hour before you have sex. Once in place, the diaphragm provides protection for 6 hours.
Getting Your Diaphragm Ready
Before you put the diaphragm in your vagina, put about 1 teaspoon of spermicidal gel or cream in the cup. Smear some more gel around the rim of the diaphragm. Do not use petroleum jelly or oil-based vaginal creams (such as Monistat). These can make tiny holes in the diaphragm.
Inserting Your Diaphragm
You can put your diaphragm in while you are lying down, squatting or standing with one leg up on a chair. Your legs need to be fairly wide open. Bending your knees can help. Once you're in position, follow these steps:
Use one hand to fold the diaphragm in half with the dome pointing down. Hold your vagina open with your other hand.
Put the diaphragm into your vagina, aiming for your tailbone. Push the diaphragm as far back into your vagina as you can.
Use one finger to push the front rim of the diaphragm up behind your pubic bone, aiming for your belly button.
Checking Placement of Your Diaphragm
With your finger, feel for your cervix through the dome of the diaphragm. The cervix will feel firm but not bony. It feels a bit like the tip of your nose.
If the diaphragm does not cover your cervix or if you cannot feel your cervix at all, the dome is not in the right place. This means that you need to remove the diaphragm, put more spermicidal gel on it, and insert it again.
The diaphragm should not fall out when you cough, squat down, sit on the toilet or walk around. If your diaphragm stays in place when you do these things, the front rim is most likely in the right place above the pubic bone.
After You Have Sex
The following are some important points to remember after you have sex:
Leave the diaphragm in place for at least 6 hours after you have sex.
If you have sex again within 6 hours, put spermicidal gel in your vagina, but do not take your diaphragm out to put gel in the dome.
Take the diaphragm out of your vagina 6 to 12 hours after you have sex.
Do not leave the diaphragm in your vagina for more than 24 hours. Doing so can cause infection, irritation or even a complication called toxic shock syndrome.
Do not douche while the diaphragm is in your vagina.
To remove the diaphragm, "hook" the front rim with your finger and pull down and out. Be careful not to tear a hole in the diaphragm with your fingernails. You should not wear your diaphragm during your menstrual period. You will need to use another method of contraception during this time.
Taking Care of Your Diaphragm
After you take the diaphragm out of your vagina, wash it with mild soap and water, rinse it and allow it to air dry. Always store your diaphragm in its container. Store the container in a cool, dry place, away from sunlight.
Check your diaphragm often for holes, tears or leaks. To do this, fill the dome with water and look for tiny leaks.
Replace your diaphragm after 1 to 2 years. Every year, your doctor should check to see that your diaphragm still fits correctly. You will need to be measured again if you have a baby, have pelvic surgery, or gain or lose more than 15 pounds.
When to Call Your Doctor
Call your doctor if you have any of the following problems:
Trouble urinating, or painful or frequent urination
Vaginal itching, discharge or discomfort
High fever (which can be a sign of toxic shock syndrome)
You also should call your doctor if your diaphragm gets a hole in it or does not seem to fit right. If your diaphragm has any of these problems, it needs to be replaced. If you keep using it as is, you could increase your risk of getting pregnant.
For effective birth control, your diaphragm (see pictures below) has to fit well. Your doctor will measure your vagina to find the correct size and fit for you.
Your doctor or a nurse will teach you how to put the diaphragm in and take it out. You also should read the directions from the company that made your diaphragm.
To be sure that you know how to use your diaphragm, you will need to practice putting it in and taking it out while you are in your doctor's office. Your doctor will check to see that the diaphragm fits right.
To lower your risk of getting pregnant, you must use your diaphragm correctly and use it every time you have sex. You must also use the diaphragm with spermicide (a gel or cream that kills sperm trying to enter the cervix) in order to prevent pregnancy. You can put the diaphragm in your vagina up to 1 hour before you have sex. Once in place, the diaphragm provides protection for 6 hours.
Getting Your Diaphragm Ready
Before you put the diaphragm in your vagina, put about 1 teaspoon of spermicidal gel or cream in the cup. Smear some more gel around the rim of the diaphragm. Do not use petroleum jelly or oil-based vaginal creams (such as Monistat). These can make tiny holes in the diaphragm.
Inserting Your Diaphragm
You can put your diaphragm in while you are lying down, squatting or standing with one leg up on a chair. Your legs need to be fairly wide open. Bending your knees can help. Once you're in position, follow these steps:
Use one hand to fold the diaphragm in half with the dome pointing down. Hold your vagina open with your other hand.
Put the diaphragm into your vagina, aiming for your tailbone. Push the diaphragm as far back into your vagina as you can.
Use one finger to push the front rim of the diaphragm up behind your pubic bone, aiming for your belly button.
Checking Placement of Your Diaphragm
With your finger, feel for your cervix through the dome of the diaphragm. The cervix will feel firm but not bony. It feels a bit like the tip of your nose.
If the diaphragm does not cover your cervix or if you cannot feel your cervix at all, the dome is not in the right place. This means that you need to remove the diaphragm, put more spermicidal gel on it, and insert it again.
The diaphragm should not fall out when you cough, squat down, sit on the toilet or walk around. If your diaphragm stays in place when you do these things, the front rim is most likely in the right place above the pubic bone.
After You Have Sex
The following are some important points to remember after you have sex:
Leave the diaphragm in place for at least 6 hours after you have sex.
If you have sex again within 6 hours, put spermicidal gel in your vagina, but do not take your diaphragm out to put gel in the dome.
Take the diaphragm out of your vagina 6 to 12 hours after you have sex.
Do not leave the diaphragm in your vagina for more than 24 hours. Doing so can cause infection, irritation or even a complication called toxic shock syndrome.
Do not douche while the diaphragm is in your vagina.
To remove the diaphragm, "hook" the front rim with your finger and pull down and out. Be careful not to tear a hole in the diaphragm with your fingernails. You should not wear your diaphragm during your menstrual period. You will need to use another method of contraception during this time.
Taking Care of Your Diaphragm
After you take the diaphragm out of your vagina, wash it with mild soap and water, rinse it and allow it to air dry. Always store your diaphragm in its container. Store the container in a cool, dry place, away from sunlight.
Check your diaphragm often for holes, tears or leaks. To do this, fill the dome with water and look for tiny leaks.
Replace your diaphragm after 1 to 2 years. Every year, your doctor should check to see that your diaphragm still fits correctly. You will need to be measured again if you have a baby, have pelvic surgery, or gain or lose more than 15 pounds.
When to Call Your Doctor
Call your doctor if you have any of the following problems:
Trouble urinating, or painful or frequent urination
Vaginal itching, discharge or discomfort
High fever (which can be a sign of toxic shock syndrome)
You also should call your doctor if your diaphragm gets a hole in it or does not seem to fit right. If your diaphragm has any of these problems, it needs to be replaced. If you keep using it as is, you could increase your risk of getting pregnant.
Emergency Contraception
What is emergency contraception?
Emergency contraception is a form of birth control. You can use this method if you have had unprotected sex and are worried that you might get pregnant. For example, if your regular birth control fails (the condom breaks during sex), if you forget to take your birth control pills or if you have sex without using any birth control.
There are 2 types of emergency contraception. With the first, you take special doses of birth control pills. With the other, an intrauterine device (also called an IUD) is placed in your uterus (or womb).
How do I use emergency contraception?
The first kind of emergency contraception, sometimes called the "morning-after pill," is taken in two doses. You can start taking this kind of emergency contraception right away after having unprotected sex. The sooner you take it, the better it works, but you can take the first dose within 120 hours (5 days) after having unprotected sex. You take the second dose 12 hours after the first dose. Your doctor may tell you about other ways of taking this medicine.
There is a brand of pills made just for emergency contraception. It is called levonorgestrel. These pills contain only progestin.
The U.S. Food and Drug Administration also has said that some brands of regular birth control pills are safe for emergency use. The number of pills you take in each dose depends on which brand of pills you are using. To learn more about which pills are safe for emergency use, talk with your doctor.
An IUD that is placed in your uterus within 7 days after unprotected sex also can be used as emergency contraception. An IUD is a small device that can be left in your body for 5 to 10 years. It will prevent pregnancy during that time.
How does emergency contraception work?
Pills used for emergency contraception can prevent your ovaries from releasing an egg, can prevent an egg from being fertilized by sperm or can prevent a fertilized egg from attaching itself to the wall of the uterus. Emergency contraceptive pills are not the same as the medicine known as the "abortion pill." This medicine is taken in the early weeks of pregnancy to end the pregnancy. Pills used as emergency contraception can't end a pregnancy once a fertilized egg has attached itself to the wall of the uterus.
Unlike the morning-after pill, an IUD doesn't stop your ovaries from releasing an egg. The IUD can prevent an egg from being fertilized and it can stop a fertilized egg from attaching itself to the wall of the uterus.
No studies have shown that taking hormones while you are pregnant can hurt your baby. However, if you know you are pregnant, you should not take emergency contraception pills.
How effective is emergency contraception?
Emergency contraceptive pills can be very effective if they are used in time. If used within 72 hours of unprotected sex, it can reduce the risk of pregnancy by 75% to 89%. It is important to remember that these pills will work best when taken as soon as possible after unprotected sex.
Emergency IUD insertion is also very effective. It can reduce the risk of pregnancy by 99.9% if inserted within 7 days after unprotected sex.
It is important to remember that using this type of contraception regularly is less effective than using ongoing methods of contraception (like normal birth control pills or diaphragms). Emergency contraception should not be your main type of contraception.
Are there any side effects?
Some women feel sick to their stomach after they take emergency contraceptive pills. This feeling should go away in about two days. Your doctor can give you medicine that may help you feel better.
Progestin-only pills may not make you feel as sick as pills containing estrogen and progestin. If you throw up within one hour of taking the pills, you may need to take another dose. Talk to your doctor.
A possible side effect of an IUD is bleeding between periods. Talk to your doctor to find out more about how IUDs work. You also can read more about IUDs on familydoctor.org.
Who can use emergency contraception?
If you can take regular birth control pills, you should be able to take emergency contraceptive pills. If you are pregnant, have breast cancer, or have had blood clots, you should not use emergency contraceptive pills. Talk with your doctor about whether emergency contraception is right for you.
You should not use an IUD if you have a sexually transmitted infection (STI) or if you have been raped. Talk to your doctor about other options.
When do I need to start taking my regular birth control again?
After you take emergency contraceptive pills, your period may come earlier or later than usual. Call your doctor if you do not get your period within 21 days after taking the pills.
If your regular form of birth control is condoms, spermicides or a diaphragm, you may go back to using them right away after taking emergency contraceptive pills.
If your regular form of birth control is the pill, shot, contraceptive patch or vaginal ring, talk to your doctor about when to start using it again.
Where can I get emergency contraception?
Talk to your doctor about how to get emergency contraception, or about having a prescription on hand in case you need it. You also may be able to get emergency contraception from university and women's health centers, health departments, Planned Parenthood centers and hospital emergency departments.
Emergency contraception is a form of birth control. You can use this method if you have had unprotected sex and are worried that you might get pregnant. For example, if your regular birth control fails (the condom breaks during sex), if you forget to take your birth control pills or if you have sex without using any birth control.
There are 2 types of emergency contraception. With the first, you take special doses of birth control pills. With the other, an intrauterine device (also called an IUD) is placed in your uterus (or womb).
How do I use emergency contraception?
The first kind of emergency contraception, sometimes called the "morning-after pill," is taken in two doses. You can start taking this kind of emergency contraception right away after having unprotected sex. The sooner you take it, the better it works, but you can take the first dose within 120 hours (5 days) after having unprotected sex. You take the second dose 12 hours after the first dose. Your doctor may tell you about other ways of taking this medicine.
There is a brand of pills made just for emergency contraception. It is called levonorgestrel. These pills contain only progestin.
The U.S. Food and Drug Administration also has said that some brands of regular birth control pills are safe for emergency use. The number of pills you take in each dose depends on which brand of pills you are using. To learn more about which pills are safe for emergency use, talk with your doctor.
An IUD that is placed in your uterus within 7 days after unprotected sex also can be used as emergency contraception. An IUD is a small device that can be left in your body for 5 to 10 years. It will prevent pregnancy during that time.
How does emergency contraception work?
Pills used for emergency contraception can prevent your ovaries from releasing an egg, can prevent an egg from being fertilized by sperm or can prevent a fertilized egg from attaching itself to the wall of the uterus. Emergency contraceptive pills are not the same as the medicine known as the "abortion pill." This medicine is taken in the early weeks of pregnancy to end the pregnancy. Pills used as emergency contraception can't end a pregnancy once a fertilized egg has attached itself to the wall of the uterus.
Unlike the morning-after pill, an IUD doesn't stop your ovaries from releasing an egg. The IUD can prevent an egg from being fertilized and it can stop a fertilized egg from attaching itself to the wall of the uterus.
No studies have shown that taking hormones while you are pregnant can hurt your baby. However, if you know you are pregnant, you should not take emergency contraception pills.
How effective is emergency contraception?
Emergency contraceptive pills can be very effective if they are used in time. If used within 72 hours of unprotected sex, it can reduce the risk of pregnancy by 75% to 89%. It is important to remember that these pills will work best when taken as soon as possible after unprotected sex.
Emergency IUD insertion is also very effective. It can reduce the risk of pregnancy by 99.9% if inserted within 7 days after unprotected sex.
It is important to remember that using this type of contraception regularly is less effective than using ongoing methods of contraception (like normal birth control pills or diaphragms). Emergency contraception should not be your main type of contraception.
Are there any side effects?
Some women feel sick to their stomach after they take emergency contraceptive pills. This feeling should go away in about two days. Your doctor can give you medicine that may help you feel better.
Progestin-only pills may not make you feel as sick as pills containing estrogen and progestin. If you throw up within one hour of taking the pills, you may need to take another dose. Talk to your doctor.
A possible side effect of an IUD is bleeding between periods. Talk to your doctor to find out more about how IUDs work. You also can read more about IUDs on familydoctor.org.
Who can use emergency contraception?
If you can take regular birth control pills, you should be able to take emergency contraceptive pills. If you are pregnant, have breast cancer, or have had blood clots, you should not use emergency contraceptive pills. Talk with your doctor about whether emergency contraception is right for you.
You should not use an IUD if you have a sexually transmitted infection (STI) or if you have been raped. Talk to your doctor about other options.
When do I need to start taking my regular birth control again?
After you take emergency contraceptive pills, your period may come earlier or later than usual. Call your doctor if you do not get your period within 21 days after taking the pills.
If your regular form of birth control is condoms, spermicides or a diaphragm, you may go back to using them right away after taking emergency contraceptive pills.
If your regular form of birth control is the pill, shot, contraceptive patch or vaginal ring, talk to your doctor about when to start using it again.
Where can I get emergency contraception?
Talk to your doctor about how to get emergency contraception, or about having a prescription on hand in case you need it. You also may be able to get emergency contraception from university and women's health centers, health departments, Planned Parenthood centers and hospital emergency departments.
Menopause: What to Expect When Your Body is Changing
What is menopause?
Menopause is when a woman’s menstrual periods permanently end. It is a normal part of a woman's life and it happens because, as a woman ages, her ovaries make less of the female hormones estrogen and progesterone. Estrogen and progesterone are the hormones that regulate your menstrual cycle.
Perimenopause is the term for the 3 to 5 years around the time of menopause and before your final period.
When does menopause occur?
The timing of actual menopause is different for each woman. The average age for women to have their last period is about 51. But it's normal for menopause to occur any time from age 40 to 59. A woman often goes through menopause at about the same age as her mother. If you stop having periods early (before age 40) your doctor can do a blood test to see if you're actually going through menopause or if there is another cause for your missed periods.
Menopause is a gradual process that can take several years. You're not really through menopause until you haven't had a period for 12 months. (During this time, keep using birth control if you don't want to become pregnant.)
Women who have both ovaries removed during surgery will go through "surgical menopause" at the time of their surgery. If the uterus is taken out but the ovaries are not, a woman will stop having periods, but she will not go through surgical menopause.
Talk to your doctor if you have:
A change in your monthly cycle
Heavy bleeding
Bleeding that lasts longer than usual
Bleeding more often than every 3 weeks
Bleeding after sexual intercourse
Any blood spotting between periods
What are the common signs and symptoms of menopause?
Some women just stop having periods. Most women experience some symptoms, such as the following:
A change in your menstrual cycle. This is one of the first signs of menopause. You may skip periods or they may occur closer together. Your flow may be lighter or heavier than usual.
Hot flashes. Hot flashes are the most common symptom of menopause.
When you have a hot flash, you'll feel warm from your chest to your head, often in wave-like sensations. Your skin may turn red and you may sweat. You may feel sick to your stomach and dizzy. You may also have a headache and feel like your heart is beating very fast and hard.
Vaginal dryness. During and after menopause, the skin of your vagina and vulva (the area around your vagina) becomes thinner. Your vagina also loses its ability to produce as much lubrication (wetness) during sexual arousal. These changes can lead to pain during sex.
You can use an over-the-counter water-based sexual lubricant (such as K-Y Jelly) or moisturizers for the vaginal area (such as Vagisil) to make sex less painful. You can also talk to your doctor about the benefits and risks of using prescription estrogen cream for vaginal changes.
Urinary tract problems. You're more likely to have bladder and urinary tract infections during and after menopause. Talk to your doctor if you have to go to the bathroom often, feel an urgent need to urinate, feel a burning sensation when urinating or are not able to urinate.
Headaches, night sweats, trouble sleeping and tiredness are other symptoms. Trouble sleeping and feeling tired may be caused by hot flashes and night sweats that keep you from getting a good night’s rest.
Weight gain. Many women gain weight during menopause. A healthy diet and exercising most, if not all, days of the week will help keep you fit.
HeIlp for hot flashes
Turn your thermostat down. Sleep in a cool room.
Dress in layers, so you can remove clothing when you get too warm.
Wear cotton and other natural fabrics that "breathe" so you don't get overheated. Use cotton sheets on your bed.
Drink cool water or other beverages when a hot flash starts.
Get plenty of exercise.
Find out what triggers your hot flashes and avoid them. Spicy foods, alcohol, tight clothing and hot humid weather are some common triggers.
Does menopause have emotional symptoms?
Many women experience emotional symptoms during menopause. These symptoms may include sadness, anxiety and mood swings. For some women, symptoms can be severe. If you find that you're having emotional problems, talk to your family doctor.
What is hormone replacement therapy?
Hormone replacement therapy (HRT) is a treatment for menopause symptoms that involves taking synthetic hormones (which are made in a laboratory rather than by the body). HRT can be estrogen taken alone or estrogen combined with another hormone, progestin. Some women have found that HRT can relieve symptoms such as hot flashes, vaginal dryness and some urinary problems. However, HRT is not for everyone. New information from recent studies suggests that for most women, the risks of using HRT may outweigh the benefits. Talk to your doctor about the risks and benefits of HRT.
Are other treatments available?
Yes. Medicines such as estrogen cream, low-dose antidepressants, soy products and certain herbal supplements may help ease some menopausal symptoms. Discuss these options with your doctor.
Menopause is when a woman’s menstrual periods permanently end. It is a normal part of a woman's life and it happens because, as a woman ages, her ovaries make less of the female hormones estrogen and progesterone. Estrogen and progesterone are the hormones that regulate your menstrual cycle.
Perimenopause is the term for the 3 to 5 years around the time of menopause and before your final period.
When does menopause occur?
The timing of actual menopause is different for each woman. The average age for women to have their last period is about 51. But it's normal for menopause to occur any time from age 40 to 59. A woman often goes through menopause at about the same age as her mother. If you stop having periods early (before age 40) your doctor can do a blood test to see if you're actually going through menopause or if there is another cause for your missed periods.
Menopause is a gradual process that can take several years. You're not really through menopause until you haven't had a period for 12 months. (During this time, keep using birth control if you don't want to become pregnant.)
Women who have both ovaries removed during surgery will go through "surgical menopause" at the time of their surgery. If the uterus is taken out but the ovaries are not, a woman will stop having periods, but she will not go through surgical menopause.
Talk to your doctor if you have:
A change in your monthly cycle
Heavy bleeding
Bleeding that lasts longer than usual
Bleeding more often than every 3 weeks
Bleeding after sexual intercourse
Any blood spotting between periods
What are the common signs and symptoms of menopause?
Some women just stop having periods. Most women experience some symptoms, such as the following:
A change in your menstrual cycle. This is one of the first signs of menopause. You may skip periods or they may occur closer together. Your flow may be lighter or heavier than usual.
Hot flashes. Hot flashes are the most common symptom of menopause.
When you have a hot flash, you'll feel warm from your chest to your head, often in wave-like sensations. Your skin may turn red and you may sweat. You may feel sick to your stomach and dizzy. You may also have a headache and feel like your heart is beating very fast and hard.
Vaginal dryness. During and after menopause, the skin of your vagina and vulva (the area around your vagina) becomes thinner. Your vagina also loses its ability to produce as much lubrication (wetness) during sexual arousal. These changes can lead to pain during sex.
You can use an over-the-counter water-based sexual lubricant (such as K-Y Jelly) or moisturizers for the vaginal area (such as Vagisil) to make sex less painful. You can also talk to your doctor about the benefits and risks of using prescription estrogen cream for vaginal changes.
Urinary tract problems. You're more likely to have bladder and urinary tract infections during and after menopause. Talk to your doctor if you have to go to the bathroom often, feel an urgent need to urinate, feel a burning sensation when urinating or are not able to urinate.
Headaches, night sweats, trouble sleeping and tiredness are other symptoms. Trouble sleeping and feeling tired may be caused by hot flashes and night sweats that keep you from getting a good night’s rest.
Weight gain. Many women gain weight during menopause. A healthy diet and exercising most, if not all, days of the week will help keep you fit.
HeIlp for hot flashes
Turn your thermostat down. Sleep in a cool room.
Dress in layers, so you can remove clothing when you get too warm.
Wear cotton and other natural fabrics that "breathe" so you don't get overheated. Use cotton sheets on your bed.
Drink cool water or other beverages when a hot flash starts.
Get plenty of exercise.
Find out what triggers your hot flashes and avoid them. Spicy foods, alcohol, tight clothing and hot humid weather are some common triggers.
Does menopause have emotional symptoms?
Many women experience emotional symptoms during menopause. These symptoms may include sadness, anxiety and mood swings. For some women, symptoms can be severe. If you find that you're having emotional problems, talk to your family doctor.
What is hormone replacement therapy?
Hormone replacement therapy (HRT) is a treatment for menopause symptoms that involves taking synthetic hormones (which are made in a laboratory rather than by the body). HRT can be estrogen taken alone or estrogen combined with another hormone, progestin. Some women have found that HRT can relieve symptoms such as hot flashes, vaginal dryness and some urinary problems. However, HRT is not for everyone. New information from recent studies suggests that for most women, the risks of using HRT may outweigh the benefits. Talk to your doctor about the risks and benefits of HRT.
Are other treatments available?
Yes. Medicines such as estrogen cream, low-dose antidepressants, soy products and certain herbal supplements may help ease some menopausal symptoms. Discuss these options with your doctor.
Genetic Testing for Breast Cancer Risk
What causes breast cancer?
It is not known exactly what causes breast cancer, but there are certain risk factors that seem to increase a person's chance of getting the disease. It's estimated that about 10% of breast cancer cases are hereditary (run in the family). In many of these cases, a person has inherited a gene from his or her parents that has mutated (changed from its normal form). This mutated gene makes it more likely for a person to get breast cancer.
What genes can cause breast cancer to be inherited?
Everyone has two genes called BRCA1 and BRCA2. Normally, these genes help to prevent cancer tumors from growing. But sometimes a person inherits an abnormal (mutated) form of BRCA1 or BRCA2 from his or her family. This person's chance of getting breast cancer increases. Women from Ashkenazi Jewish families are more likely than other women to carry abnormal BRCA1 and BRCA2. Mutations in these genes have also been linked to ovarian cancer.
Besides BRCA1 and BRCA2, there are other mutated genes that may make it more likely for a person to get breast cancer. Scientists know about some of these genes, and they are working to identify others.
What clues in my family history might show I've inherited a risk of breast cancer?
Breast cancer in 2 or more first-degree relatives is a sign that the mutated form of BRCA1 or BRCA2 might run in your family. First-degree relatives include your parents, siblings and children. Another sign of a risk of inherited breast cancer is a first-degree relative who got breast cancer before the age of 50. If you have a first-degree relative with ovarian cancer for example, that might also mean that you risk carrying one of the mutated genes.
Does everyone who has family members with breast cancer have these mutated genes?
No. The chances of inheriting breast cancer aren't high, even if someone in your family has had the disease. Many people have parents, siblings or children who have had breast cancer without carrying a mutated form of BRCA1 or BRCA2. Although anyone with first-degree relatives who have had breast cancer is at increased risk, most people don't get the inherited kind of breast cancer.
Breast cancer seems to run in my family. What should I do?
Talk with your doctor about your family history. For example, your doctor will want to know how you are related to any family members who have had breast cancer. Your doctor will also want to know how old your relatives were when their breast cancer was diagnosed.
Should I have a test to find out if I carry the breast cancer gene?
The choice is up to you and your doctor. Your doctor can help you decide if a gene test might be useful to you. He or she can also discuss the pros and cons of taking the test. Talking with a genetic counselor might also be helpful.
Think about how you would feel if the test results show that you carry an abnormal BRCA1 or BRCA2 gene and are at greater risk of getting breast cancer. Some people want to know if they have one of the mutated genes. Knowing, instead of wondering, helps them deal with the risk of breast cancer. It allows them and their doctors to watch more closely for early signs of cancer. But other people would rather not know they have the abnormal gene because it would be too hard to cope with. Talk with your doctor about your feelings. It's important to note that even if you have a mutated BRCA1 or BRCA2 gene, your chances of developing breast cancer are still very low.
It is not known exactly what causes breast cancer, but there are certain risk factors that seem to increase a person's chance of getting the disease. It's estimated that about 10% of breast cancer cases are hereditary (run in the family). In many of these cases, a person has inherited a gene from his or her parents that has mutated (changed from its normal form). This mutated gene makes it more likely for a person to get breast cancer.
What genes can cause breast cancer to be inherited?
Everyone has two genes called BRCA1 and BRCA2. Normally, these genes help to prevent cancer tumors from growing. But sometimes a person inherits an abnormal (mutated) form of BRCA1 or BRCA2 from his or her family. This person's chance of getting breast cancer increases. Women from Ashkenazi Jewish families are more likely than other women to carry abnormal BRCA1 and BRCA2. Mutations in these genes have also been linked to ovarian cancer.
Besides BRCA1 and BRCA2, there are other mutated genes that may make it more likely for a person to get breast cancer. Scientists know about some of these genes, and they are working to identify others.
What clues in my family history might show I've inherited a risk of breast cancer?
Breast cancer in 2 or more first-degree relatives is a sign that the mutated form of BRCA1 or BRCA2 might run in your family. First-degree relatives include your parents, siblings and children. Another sign of a risk of inherited breast cancer is a first-degree relative who got breast cancer before the age of 50. If you have a first-degree relative with ovarian cancer for example, that might also mean that you risk carrying one of the mutated genes.
Does everyone who has family members with breast cancer have these mutated genes?
No. The chances of inheriting breast cancer aren't high, even if someone in your family has had the disease. Many people have parents, siblings or children who have had breast cancer without carrying a mutated form of BRCA1 or BRCA2. Although anyone with first-degree relatives who have had breast cancer is at increased risk, most people don't get the inherited kind of breast cancer.
Breast cancer seems to run in my family. What should I do?
Talk with your doctor about your family history. For example, your doctor will want to know how you are related to any family members who have had breast cancer. Your doctor will also want to know how old your relatives were when their breast cancer was diagnosed.
Should I have a test to find out if I carry the breast cancer gene?
The choice is up to you and your doctor. Your doctor can help you decide if a gene test might be useful to you. He or she can also discuss the pros and cons of taking the test. Talking with a genetic counselor might also be helpful.
Think about how you would feel if the test results show that you carry an abnormal BRCA1 or BRCA2 gene and are at greater risk of getting breast cancer. Some people want to know if they have one of the mutated genes. Knowing, instead of wondering, helps them deal with the risk of breast cancer. It allows them and their doctors to watch more closely for early signs of cancer. But other people would rather not know they have the abnormal gene because it would be too hard to cope with. Talk with your doctor about your feelings. It's important to note that even if you have a mutated BRCA1 or BRCA2 gene, your chances of developing breast cancer are still very low.
Sexual Dysfunction in Women
What is sexual dysfunction?
When you have problems with sex, doctors call it "sexual dysfunction." Both men and women can have it. There are 4 kinds of sexual problems in women.
Desire disorders - When you are not interested in having sex or have less desire for sex than you used to.
Arousal disorders - When you don't feel a sexual response in your body or you cannot stay sexually aroused.
Orgasmic disorders - When you can't have an orgasm or you have pain during orgasm.
Sexual pain disorders - When you have pain during or after sex.
What causes sexual dysfunction?
Many things can cause problems in your sex life. Certain medicines (such as oral contraceptives and chemotherapy drugs), diseases (such as diabetes or high blood pressure), excessive alcohol use or vaginal infections can cause sexual problems. Depression, relationship problems or abuse (current or past abuse) can also cause sexual dysfunction.
You may have less sexual desire during pregnancy, right after childbirth or when you are breastfeeding. After menopause many women feel less sexual desire, have vaginal dryness or have pain during sex due to a decrease in estrogen (a hormone in the body).
The stresses of everyday life can also affect your ability to have sex. Being tired from a busy job or caring for young children may affect your sexual desire. You may also be bored by a long-standing sexual routine.
How do I know if I have a problem?
Up to 70% of couples have a problem with sex at some time in their relationships. Most women will have sex that doesn't feel good at some point in her life. This doesn't necessarily mean you have a sexual problem.
If you don't want to have sex or it never feels good, you might have a sexual problem. Discuss your concerns with your doctor. Remember that anything you tell your doctor is private and that your doctor can help you find a reason and possible treatment for your sexual dysfunction.
Return to top
What can I do?
If desire is the problem, try changing your usual routine. Try having sex at different times of the day, or try a different sexual position.
Arousal disorders can often be helped if you use a vaginal cream or sexual lubricant for dryness. If you have gone through menopause, talk to your doctor about taking estrogen or using an estrogen cream.
If you have a problem having an orgasm, you may not be getting enough foreplay or stimulation before actual intercourse begins. Extra stimulation (before you have sex with your partner) with a vibrator may be helpful. You might need rubbing or stimulation for up to an hour before having sex. Many women don't have an orgasm during intercourse. If you want an orgasm with intercourse, you or your partner may want to gently stroke your clitoris. Masturbation may also be helpful, as it can help you learn what techniques work best for you.
If you're having pain during sex, try different positions. When you are on top, you have more control over penetration and movement. Emptying your bladder before you have sex, using extra lubrication or taking a warm bath before sex all may help. If you still have pain during sex, talk to your doctor. He or she can help you find the cause of your pain and decide what treatment is best for you.
Can medicine help?
If you have gone through menopause or have had your uterus and/or ovaries removed, taking the hormone estrogen may help with sexual problems. If you're not already taking estrogen, ask your doctor if this is an option for you.
You may have heard that taking sildenafil (Viagra) or the male hormone testosterone can help women with sexual problems. There have not been many studies on the effects of Viagra or testosterone on women, so doctors do not know whether these things can help or not. Both Viagra and testosterone can have serious side effects, so using them is probably not worth the risk.
What else can I do?
Learn more about your body and how it works. Ask your doctor about how medicines, illnesses, surgery, age, pregnancy or menopause can affect sex.
Practice "sensate focus" exercises where one partner gives a massage, while the other partner says what feels good and requests changes (example: "lighter," "faster," etc.). Fantasizing may increase your desire. Squeezing the muscles of your vagina tightly (called Kegel exercises) and then relaxing them may also increase your arousal. Try sexual activity other than intercourse, such as massage, oral sex or masturbation.
What about my partner?
Talk with your partner about what each of you like and dislike, or what you might want to try. Ask for your partner's help. Remember that your partner may not want to do some things you want to try, and you may not want to try what your partner wants. You should respect each other's comforts and discomforts. This helps you and your partner have a good sexual relationship. If you feel you can't talk to your partner, your doctor or a counselor may be able to help you.
If you feel like your partner is abusing you, tell your doctor.
How can my doctor help?
Your doctor can suggest ways to treat your sexual problems or can refer you to a sex therapist or counselor if needed.
When you have problems with sex, doctors call it "sexual dysfunction." Both men and women can have it. There are 4 kinds of sexual problems in women.
Desire disorders - When you are not interested in having sex or have less desire for sex than you used to.
Arousal disorders - When you don't feel a sexual response in your body or you cannot stay sexually aroused.
Orgasmic disorders - When you can't have an orgasm or you have pain during orgasm.
Sexual pain disorders - When you have pain during or after sex.
What causes sexual dysfunction?
Many things can cause problems in your sex life. Certain medicines (such as oral contraceptives and chemotherapy drugs), diseases (such as diabetes or high blood pressure), excessive alcohol use or vaginal infections can cause sexual problems. Depression, relationship problems or abuse (current or past abuse) can also cause sexual dysfunction.
You may have less sexual desire during pregnancy, right after childbirth or when you are breastfeeding. After menopause many women feel less sexual desire, have vaginal dryness or have pain during sex due to a decrease in estrogen (a hormone in the body).
The stresses of everyday life can also affect your ability to have sex. Being tired from a busy job or caring for young children may affect your sexual desire. You may also be bored by a long-standing sexual routine.
How do I know if I have a problem?
Up to 70% of couples have a problem with sex at some time in their relationships. Most women will have sex that doesn't feel good at some point in her life. This doesn't necessarily mean you have a sexual problem.
If you don't want to have sex or it never feels good, you might have a sexual problem. Discuss your concerns with your doctor. Remember that anything you tell your doctor is private and that your doctor can help you find a reason and possible treatment for your sexual dysfunction.
Return to top
What can I do?
If desire is the problem, try changing your usual routine. Try having sex at different times of the day, or try a different sexual position.
Arousal disorders can often be helped if you use a vaginal cream or sexual lubricant for dryness. If you have gone through menopause, talk to your doctor about taking estrogen or using an estrogen cream.
If you have a problem having an orgasm, you may not be getting enough foreplay or stimulation before actual intercourse begins. Extra stimulation (before you have sex with your partner) with a vibrator may be helpful. You might need rubbing or stimulation for up to an hour before having sex. Many women don't have an orgasm during intercourse. If you want an orgasm with intercourse, you or your partner may want to gently stroke your clitoris. Masturbation may also be helpful, as it can help you learn what techniques work best for you.
If you're having pain during sex, try different positions. When you are on top, you have more control over penetration and movement. Emptying your bladder before you have sex, using extra lubrication or taking a warm bath before sex all may help. If you still have pain during sex, talk to your doctor. He or she can help you find the cause of your pain and decide what treatment is best for you.
Can medicine help?
If you have gone through menopause or have had your uterus and/or ovaries removed, taking the hormone estrogen may help with sexual problems. If you're not already taking estrogen, ask your doctor if this is an option for you.
You may have heard that taking sildenafil (Viagra) or the male hormone testosterone can help women with sexual problems. There have not been many studies on the effects of Viagra or testosterone on women, so doctors do not know whether these things can help or not. Both Viagra and testosterone can have serious side effects, so using them is probably not worth the risk.
What else can I do?
Learn more about your body and how it works. Ask your doctor about how medicines, illnesses, surgery, age, pregnancy or menopause can affect sex.
Practice "sensate focus" exercises where one partner gives a massage, while the other partner says what feels good and requests changes (example: "lighter," "faster," etc.). Fantasizing may increase your desire. Squeezing the muscles of your vagina tightly (called Kegel exercises) and then relaxing them may also increase your arousal. Try sexual activity other than intercourse, such as massage, oral sex or masturbation.
What about my partner?
Talk with your partner about what each of you like and dislike, or what you might want to try. Ask for your partner's help. Remember that your partner may not want to do some things you want to try, and you may not want to try what your partner wants. You should respect each other's comforts and discomforts. This helps you and your partner have a good sexual relationship. If you feel you can't talk to your partner, your doctor or a counselor may be able to help you.
If you feel like your partner is abusing you, tell your doctor.
How can my doctor help?
Your doctor can suggest ways to treat your sexual problems or can refer you to a sex therapist or counselor if needed.
Breast Problems in Men
Although many people only associate breast problems with women, men can also be affected. If you have noticed changes in your breasts or nipples, follow this chart for more information.
SYMPTOMS DIAGNOSIS SELF-CARE
1. Are you between the ages of 10 and 25, and do you have swelling under and/or around one or both nipples? Hormone changes in puberty may cause GYNECOMASTIA, a benign (not cancerous) swelling of the male breast. In most cases gynecomastia will go away on its own within 2 or 3 years. See your doctor if you're concerned, if breast tenderness is a problem or if the breast tissue keeps growing.
2. Are you taking any hormones or new medicines, and do you have swelling under and/or around one or both nipples? Hormones and some types of medicine may cause GYNECOMASTIA, a benign (not cancerous) swelling of the male breast. Discuss this with your doctor.
3. Is your nipple red, sore, cracked or blistered, and do you run or wear loose gym clothing? You may have RUNNER'S NIPPLE, an irritation caused by clothes that rub against the skin. Wear soft, loose clothes and use an antibiotic ointment and adhesive bandage strips on your nipples when you run. Petroleum jelly may work just as well. If a growth occurs, have it checked by your doctor.
4. Do you have a tender breast lump that feels like a soft grape? You may have a cyst. Cysts are usually benign (not cancerous). See your doctor. He or she will determine if you need any additional tests. If your cyst is painful, your doctor may use a small needle to drain fluid from it.
5. Do you have a painless lump that feels rubbery and is easily moveable within the breast tissue? Although more common in women, FIBROADENOMAS, benign (not cancerous) lumps, may also occur in men. Make an appointment with your doctor. He or she will determine if you need additional tests.
6. Do you have a hard, painless lump under your nipple, and have you noticed any breast changes such as skin dimpling or puckering, redness or scaling of the nipple or breast skin, or have you had any nipple discharge? This may be a sign of something serious, like CANCER. MAKE AN APPOINTMENT WITH YOUR DOCTOR RIGHT AWAY.
For more information, please talk to your doctor. If you think your problem is serious, call right away.
SYMPTOMS DIAGNOSIS SELF-CARE
1. Are you between the ages of 10 and 25, and do you have swelling under and/or around one or both nipples? Hormone changes in puberty may cause GYNECOMASTIA, a benign (not cancerous) swelling of the male breast. In most cases gynecomastia will go away on its own within 2 or 3 years. See your doctor if you're concerned, if breast tenderness is a problem or if the breast tissue keeps growing.
2. Are you taking any hormones or new medicines, and do you have swelling under and/or around one or both nipples? Hormones and some types of medicine may cause GYNECOMASTIA, a benign (not cancerous) swelling of the male breast. Discuss this with your doctor.
3. Is your nipple red, sore, cracked or blistered, and do you run or wear loose gym clothing? You may have RUNNER'S NIPPLE, an irritation caused by clothes that rub against the skin. Wear soft, loose clothes and use an antibiotic ointment and adhesive bandage strips on your nipples when you run. Petroleum jelly may work just as well. If a growth occurs, have it checked by your doctor.
4. Do you have a tender breast lump that feels like a soft grape? You may have a cyst. Cysts are usually benign (not cancerous). See your doctor. He or she will determine if you need any additional tests. If your cyst is painful, your doctor may use a small needle to drain fluid from it.
5. Do you have a painless lump that feels rubbery and is easily moveable within the breast tissue? Although more common in women, FIBROADENOMAS, benign (not cancerous) lumps, may also occur in men. Make an appointment with your doctor. He or she will determine if you need additional tests.
6. Do you have a hard, painless lump under your nipple, and have you noticed any breast changes such as skin dimpling or puckering, redness or scaling of the nipple or breast skin, or have you had any nipple discharge? This may be a sign of something serious, like CANCER. MAKE AN APPOINTMENT WITH YOUR DOCTOR RIGHT AWAY.
For more information, please talk to your doctor. If you think your problem is serious, call right away.
Breast Problems in Women
Breast lumps, pain, discharge or skin problems can be a sign of a minor problem or something more serious, so it's important to pay attention to any changes. Follow this chart for more information about breast problems.
SYMPTOMS DIAGNOSIS SELF-CARE
1. Do you have swelling and tenderness in one or both breasts? Go to Question 6.*
2. Have you given birth recently?
Soon after giving birth, your breasts could become engorged with milk, causing swelling and tenderness.
Breast pain along with redness, nipple discharge, itching or a fever, could be a sign of MASTITIS, an infection of a milk duct.
If your breasts are engorged, applying warm compresses to the breast and gently expressing some milk may help.
If you have an infection, talk to your doctor. He or she may give you an antibiotic.
3. Did the tenderness start recently, and do your breasts feel fuller and heavier? You may be PREGNANT. Changes in the way your breasts feel, fatigue, nausea and frequent urination are some of the early signs of pregnancy Take an at-home pregnancy test. If it's positive, see your doctor.
4. Do the swelling and tenderness seem to occur at about the same time during every menstrual cycle? Go to Question 6.*
5. Do you feel thickened, bumpy areas throughout your breast? Your symptoms may be a result of HORMONAL CHANGES during your menstrual cycle. If you also have irritability, trouble sleeping and mood changes, you may have PREMENSTRUAL SYNDROME (PMS).
Over-the-counter medicines may help relieve bloating and tenderness. Ibuprofen or naproxen may be helpful for painful periods. Avoid caffeine, alcohol, sugary foods and excess salt. If your symptoms are severe, your doctor may prescribe a medicine to relieve them.
Your symptoms may be caused by FIBROCYSTIC DISEASE. See your doctor. He or she may recommend that you avoid fatty foods and caffeine.
*6. Do you feel a tender lump, smaller than a penny, that wasn't there last month? This lump may be a noncancerous GROWTH or CYST. Carefully check this lump for a month. If it doesn't go away or it changes, see your doctor.
7. Do you feel a painless lump that is deep in your breast, possibly attached to your ribs? A painless, firm lump may be a sign of a more serious problem, such as BREAST CANCER. See your doctor as soon as possible.
8. Are you breastfeeding and having pain and cracking of the nipple? Persistent pain and cracking in the nipple with breastfeeding could mean INFECTION, or it could mean that your baby is not latching properly. Try a lanolin ointment on your nipple. If it doesn't help, see your doctor or a lactation consultant.
9. Have you noticed any breast changes such as skin dimpling or puckering, redness or scaling of the nipple or breast skin, or have you had any nipple discharge? These changes may be a sign of a serious problem, such as BREAST CANCER See your doctor as soon as possible.
10. Do you have a sore on your breast that won't heal? A nonhealing sore on the breast could be a sign of a serious problem. See your doctor.
For more information, please talk to your doctor. If you think your problem is serious, call right away.
SYMPTOMS DIAGNOSIS SELF-CARE
1. Do you have swelling and tenderness in one or both breasts? Go to Question 6.*
2. Have you given birth recently?
Soon after giving birth, your breasts could become engorged with milk, causing swelling and tenderness.
Breast pain along with redness, nipple discharge, itching or a fever, could be a sign of MASTITIS, an infection of a milk duct.
If your breasts are engorged, applying warm compresses to the breast and gently expressing some milk may help.
If you have an infection, talk to your doctor. He or she may give you an antibiotic.
3. Did the tenderness start recently, and do your breasts feel fuller and heavier? You may be PREGNANT. Changes in the way your breasts feel, fatigue, nausea and frequent urination are some of the early signs of pregnancy Take an at-home pregnancy test. If it's positive, see your doctor.
4. Do the swelling and tenderness seem to occur at about the same time during every menstrual cycle? Go to Question 6.*
5. Do you feel thickened, bumpy areas throughout your breast? Your symptoms may be a result of HORMONAL CHANGES during your menstrual cycle. If you also have irritability, trouble sleeping and mood changes, you may have PREMENSTRUAL SYNDROME (PMS).
Over-the-counter medicines may help relieve bloating and tenderness. Ibuprofen or naproxen may be helpful for painful periods. Avoid caffeine, alcohol, sugary foods and excess salt. If your symptoms are severe, your doctor may prescribe a medicine to relieve them.
Your symptoms may be caused by FIBROCYSTIC DISEASE. See your doctor. He or she may recommend that you avoid fatty foods and caffeine.
*6. Do you feel a tender lump, smaller than a penny, that wasn't there last month? This lump may be a noncancerous GROWTH or CYST. Carefully check this lump for a month. If it doesn't go away or it changes, see your doctor.
7. Do you feel a painless lump that is deep in your breast, possibly attached to your ribs? A painless, firm lump may be a sign of a more serious problem, such as BREAST CANCER. See your doctor as soon as possible.
8. Are you breastfeeding and having pain and cracking of the nipple? Persistent pain and cracking in the nipple with breastfeeding could mean INFECTION, or it could mean that your baby is not latching properly. Try a lanolin ointment on your nipple. If it doesn't help, see your doctor or a lactation consultant.
9. Have you noticed any breast changes such as skin dimpling or puckering, redness or scaling of the nipple or breast skin, or have you had any nipple discharge? These changes may be a sign of a serious problem, such as BREAST CANCER See your doctor as soon as possible.
10. Do you have a sore on your breast that won't heal? A nonhealing sore on the breast could be a sign of a serious problem. See your doctor.
For more information, please talk to your doctor. If you think your problem is serious, call right away.
Saturday, March 12, 2011
BREAST HEALTH (Bra fit basics)
As girls reach puberty, they closely monitor the amazing and mystifying ways their bodies shift toward adulthood. Of all the changes, though, none is more closely watched and wondered about than breast changes. Girls watch the silhouettes of friends for hints, look to their moms and to movie stars and wonder: What will mine look like? How big will they be? When will I need a bra - and what size will it be?
For some women, their first bra wasn't really for support. Those training bras - simple, bandage-like pieces of fabric with basic clasps and, often, a tiny, delicate bow sewn between the cups - were probably bought to provide coverage during gym class. For others, that first bra was an absolute necessity for support and coverage.
No matter what her size, a woman's breasts need support. That's because a woman's breasts have no natural support system. The breasts contain no muscles to hold them up, instead relying on the skin and a network of underlying connective tissue called the "Cooper's ligaments" for minimal support.
As a woman moves, so do her breasts - vertically, horizontally, and in an overall figure-8 like motion. If not properly supported, breasts can move too much and cause pain and discomfort - especially during exercise. A bra can reduce excessive motion and prop up the breasts to help slow sagging that comes with age and movement.
Unfortunately, it's estimated that 8 out of 10 women wear the wrong size bra. A woman chooses a bra size based on two components - the cup size, noted by letters, and the band size, noted in inches. Cup size is measured at the fullest point of the breasts, and the band size is determined by measuring the distance around a woman's back right beneath her breasts.
There are lots of reasons why women calculate this bra equation incorrectly, like not switching sizes when weight fluctuates. In many cases, women pay more attention to cup size than to band size, often choosing a cup size that is too small and a back size that is too large. A lot of cultural emphasis is put on cup size. Stuck in an A-cup, a woman may feel less feminine, while going beyond D cup can seem like crossing into forbidden "fat" territory.
But when a woman wears a bra in which the band size is too large, she depends on tightening the shoulder straps to keep the breasts propped up. Ill-fitted shoulder straps droop or dig into the skin and can cause muscle tightness that may trigger aches and pains. A properly-fitted band fits around the smallest part of a woman's back, midway between shoulders and elbows. At this position, a bra can provide adequate support, lift the breasts, and accentuate a woman's waistline. Consider going up a cup size and down a band inch.
So, forget the stigmas and go for fit. In fact, go for a fitting! A professional bra-fitting can help women find not only the perfect bra size but also the perfect bra type for her figure. A full-cup bra will cover much of the breast, while a balconette (A.K.A. shelf bra, demi-cup, half-cup) is cut horizontally across the breast. A plunge-style bra dips down into the cleavage.
Women should also invest in a well-fitted sports bra. All the up-and-down, side-to-side, and figure-8 movement during exercise can be a real pain, no matter what size of breasts a woman has. Luckily, the sports bra has come a long way since its beginnings as sewn-together jockstraps. Nowadays, a woman can choose the more traditional "compression" sports bra, which flattens the breasts against the chest. Or she can opt for a sports bra with moulded cups to support each breast separately. The compression sports bra is thought to be more effective to reduce movement for smaller breasts, while the moulded cup sports bra is thought to be more effective for larger breasts. However, some research has noted that these double-cupped sports bras more effectively reduce motion for both larger and smaller breasts. Women should try both types to see what is most comfortable for them.
For some women, their first bra wasn't really for support. Those training bras - simple, bandage-like pieces of fabric with basic clasps and, often, a tiny, delicate bow sewn between the cups - were probably bought to provide coverage during gym class. For others, that first bra was an absolute necessity for support and coverage.
No matter what her size, a woman's breasts need support. That's because a woman's breasts have no natural support system. The breasts contain no muscles to hold them up, instead relying on the skin and a network of underlying connective tissue called the "Cooper's ligaments" for minimal support.
As a woman moves, so do her breasts - vertically, horizontally, and in an overall figure-8 like motion. If not properly supported, breasts can move too much and cause pain and discomfort - especially during exercise. A bra can reduce excessive motion and prop up the breasts to help slow sagging that comes with age and movement.
Unfortunately, it's estimated that 8 out of 10 women wear the wrong size bra. A woman chooses a bra size based on two components - the cup size, noted by letters, and the band size, noted in inches. Cup size is measured at the fullest point of the breasts, and the band size is determined by measuring the distance around a woman's back right beneath her breasts.
There are lots of reasons why women calculate this bra equation incorrectly, like not switching sizes when weight fluctuates. In many cases, women pay more attention to cup size than to band size, often choosing a cup size that is too small and a back size that is too large. A lot of cultural emphasis is put on cup size. Stuck in an A-cup, a woman may feel less feminine, while going beyond D cup can seem like crossing into forbidden "fat" territory.
But when a woman wears a bra in which the band size is too large, she depends on tightening the shoulder straps to keep the breasts propped up. Ill-fitted shoulder straps droop or dig into the skin and can cause muscle tightness that may trigger aches and pains. A properly-fitted band fits around the smallest part of a woman's back, midway between shoulders and elbows. At this position, a bra can provide adequate support, lift the breasts, and accentuate a woman's waistline. Consider going up a cup size and down a band inch.
So, forget the stigmas and go for fit. In fact, go for a fitting! A professional bra-fitting can help women find not only the perfect bra size but also the perfect bra type for her figure. A full-cup bra will cover much of the breast, while a balconette (A.K.A. shelf bra, demi-cup, half-cup) is cut horizontally across the breast. A plunge-style bra dips down into the cleavage.
Women should also invest in a well-fitted sports bra. All the up-and-down, side-to-side, and figure-8 movement during exercise can be a real pain, no matter what size of breasts a woman has. Luckily, the sports bra has come a long way since its beginnings as sewn-together jockstraps. Nowadays, a woman can choose the more traditional "compression" sports bra, which flattens the breasts against the chest. Or she can opt for a sports bra with moulded cups to support each breast separately. The compression sports bra is thought to be more effective to reduce movement for smaller breasts, while the moulded cup sports bra is thought to be more effective for larger breasts. However, some research has noted that these double-cupped sports bras more effectively reduce motion for both larger and smaller breasts. Women should try both types to see what is most comfortable for them.
Monday, March 7, 2011
INFERTILITY IN MALE
Learn About Infertility, Male
What is Infertility, Male?
Conceiving a child is always far from predictable, but when a couple has not succeeded after a year of having sex without any form of contraception--especially during the woman's most fertile days of the month--there may be a fertility problem. It was previously believed that the inability to conceive occurred equally in males and females. However, a multi-center study by the World Health Organization found that males contribute to a couple’s infertility less frequently than females. The study found that about 20% of cases are attributable to the male and 38% to the female while both partners are infertile in 27% of cases: in the remaining 15% of cases, the cause is unknown. (1)
In addition to inability to conceive after a year of trying, male infertility is defined by a total sperm count of less than 5 million per ml, the presence of more than 50% abnormal sperm, and/or inability of the sperm to impregnate an egg in the laboratory.
While some causes of infertility in men cannot be reversed, a diagnosis of male infertility does not always mean that conceiving a child is impossible; it simply means that becoming pregnant may be more challenging for the couple. There are many methods and technologies today that can assist in the pursuit of parenthood. Seeking professional advice early can prevent delays in the goal of starting a family.
Despite the prolonged frustration that results from infertility, the statistics are encouraging: Up to 60% of couples who haven't conceived after a year of trying will do so eventually—with or without treatment.
What is Infertility, Male?
Conceiving a child is always far from predictable, but when a couple has not succeeded after a year of having sex without any form of contraception--especially during the woman's most fertile days of the month--there may be a fertility problem. It was previously believed that the inability to conceive occurred equally in males and females. However, a multi-center study by the World Health Organization found that males contribute to a couple’s infertility less frequently than females. The study found that about 20% of cases are attributable to the male and 38% to the female while both partners are infertile in 27% of cases: in the remaining 15% of cases, the cause is unknown. (1)
In addition to inability to conceive after a year of trying, male infertility is defined by a total sperm count of less than 5 million per ml, the presence of more than 50% abnormal sperm, and/or inability of the sperm to impregnate an egg in the laboratory.
While some causes of infertility in men cannot be reversed, a diagnosis of male infertility does not always mean that conceiving a child is impossible; it simply means that becoming pregnant may be more challenging for the couple. There are many methods and technologies today that can assist in the pursuit of parenthood. Seeking professional advice early can prevent delays in the goal of starting a family.
Despite the prolonged frustration that results from infertility, the statistics are encouraging: Up to 60% of couples who haven't conceived after a year of trying will do so eventually—with or without treatment.
Friday, March 4, 2011
What is Infertility, Female?
When a woman hasn't conceived after a year of regular, unprotected intercourse during her most fertile times of the month (before and during ovulation), infertility is a possibility that she and her partner must consider. The problem affects about 10 million Americans. In 40% of infertile couples, it's the woman who has problems that prevent pregnancy. In another 40% of cases, the primary cause lies with the man. In the remaining 20%, both partners have factors that stand in the way of conceiving a child.
A diagnosis of female infertility does not mean that you cannot conceive a child; it simply means that becoming pregnant may be more challenging for you and your partner. There are many methods and technologies today that can assist you in your pursuit to become parents.
Today women are waiting longer to start a family. As fertility declines with age, a woman who is over 35 and trying to conceive is advised to seek help after six months of trying to become pregnant. By seeking professional advice you can prevent further delay to your goal of starting a family.Read more about infertility>>
A diagnosis of female infertility does not mean that you cannot conceive a child; it simply means that becoming pregnant may be more challenging for you and your partner. There are many methods and technologies today that can assist you in your pursuit to become parents.
Today women are waiting longer to start a family. As fertility declines with age, a woman who is over 35 and trying to conceive is advised to seek help after six months of trying to become pregnant. By seeking professional advice you can prevent further delay to your goal of starting a family.Read more about infertility>>
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