FREQUENTLY ASKED QUESTIONS

Sometimes people are too embarrassed, too busy, or just don’t know the right questions. The questions on this page should cover a lot of aspects of what you need to know though.

OTHER TOPICS

Are premenstrual symptoms real?

Yes, it’s not a myth! Eight out of ten women do experience some discomfort shortly before their monthly period sets in. These symptoms are caused by the hormonal changes of the cycle and for many women they are so severe that they impact on their daily lives – both in personal and working aspects. However, cycle-related symptoms are still subject to skepticism – men in particular take it as a bad excuse for women to be short-tempered and to graze uncontrollably. What you should know:

Most common premenstrual symptoms are divided into two groups:
Affective: depressive mood, angry outbursts, irritability, anxiety, confusion, social withdrawal
Somatic: breast tenderness, abdominal bloating, headache, swelling of extremities

Medical researchers are still working on identifying the exact cause of these symptoms but it is certain that they are linked to the hormonal fluctuations during the menstrual cycle. Some combined contraceptive pills are proven to reduce these symptoms. Please talk to your health care provider in case you are heavily suffering from these symptoms.

Are cycle-related symptoms common?

You are not alone! Cycle-related symptoms are experienced by about eight out of ten women at some stage during their fertile lives. If you complain about disturbances such as excessive cravings, you may experience symptoms that differ from those your sister or your best friend is suffering from. Even if your symptoms are identical to someone else‘s, you may feel them more or less intensely. If you suffer from any of these symptoms on a regular basis, always a few days before your period sets in, talk to your doctor or healthcare provider.

Period pain comes with the territory?

Abdominal cramps, headaches and back pain, breast tenderness, mood swings or nausea, for many women make periods a regular misery. But you should certainly not suffer severe discomfort in silence. Consult your doctor or healthcare provider so they can investigate possible causes and ask about ways you can alleviate pain relating to your menstrual cycle. Some hormonal methods of contraception such as the pill or the hormonal IUS can make periods lighter and therefore more bearable, for example, by slowing down or preventing the growth of the uterine lining. This usually also means: less pain and fewer limitations, e.g. in terms of holidays, exercising and sex.

Is having sex during your period safe?

Not using contraception during your period is a dangerous game, because it is actually possible for fertilization to occur during this phase of your menstrual cycle! The length of the menstrual cycle varies from woman to woman between 21 and 35 days. Ovulation almost always occurs around two weeks before your period, i.e. between day 7 and 21 of your cycle. Because the life span of sperm is unpredictable, unprotected sex can lead to pregnancy from the first day of your period.

Another thing is some women misinterpret breakthrough bleeding as a period and think they are "safe". So if you don't wish to become pregnant, you should always use contraception without interruptions.

A period every month - my body can do without that.

There is a stubborn myth that your monthly period is a form of body "cleansing" that washes germs or dead cells out of your uterus. But the truth is: bleeding every month is of no benefit from a medical viewpoint. It does not therefore do any harm if your period is shorter or lighter as a result of hormonal contraception.

From a historical perspective, women have never had as many periods as they do now: up to 450 in a lifetime! In the past, by contrast, there were many more times when women did not have periods because of more frequent pregnancies with extensive periods of breastfeeding. This resulted in only about 150 menstruations during your Grandma’s lifespan.

Do I need to take a break from hormones to allow the body to "recover"?

There is still an old-fashioned opinion floating around that long-term users of hormonal contraceptives should take a regular break from use for a few months to allow the body to "recover" from the hormones contained in it. This is why some women still come off hormonal contraceptives for several weeks or months at a time. We now know that there is no reason to take a break from taking hormones, and it may even be harmful.

Taking breaks like this does not improve your ability to conceive either: the length of time for which you take hormones has no influence on that.

I missed a pill from my packet / I've vomited / I’ve had diarrhea? What should I do?

Do I take the pill every day?

It depends on the type of pill. Most pills work across a 28 day cycle including the pill-free or placebo interval, which means you have one pack for each cycle.
With some you have to take a hormonal pill every day. With others you take a hormonal pill every day for 21 or 24 or even 26 days of the cycle, and then have a hormone free break of seven or four or only two days where either no pills are taken or a hormone free pill is taken.
During this break, you will still be protected and you will have a menstruation-like bleed.

Is cramping during pregnancy normal?

Early in pregnancy, uterine cramping can indicate normal changes of pregnancy initiated by hormonal changes; later in pregnancy, it can indicate a growing uterus. Cramping that is different from previous pregnancies, worsening cramping, or cramping associated with any vaginal bleeding may be a sign of ectopic pregnancy, threatened abortion, or missed abortion.

Other physical effects that are normal during pregnancy, and not necessarily signs of disease, include nausea, vomiting, increase in abdominal girth, changes in bowel habits, increased urinary frequency, palpitations or more rapid heartbeat, upheaving of the chest (particularly with breathing), heart murmurs, swelling of the ankles, and shortness of breath.

What are the first symptoms of pregnancy?

Missing a period is usually the first signal of a new pregnancy, although women with irregular periods may not initially recognize a missed period as pregnancy. During this time, many women experience a need to urinate frequently, extreme fatigue, nausea and/or vomiting, and increased breast tenderness. All of these symptoms can be normal. Most over-the-counter pregnancy tests are sensitive 9-12 days after conception, and they are readily available at most drug stores. Performing these tests early helps to allay confusion and guesswork. A serum pregnancy test (performed in a provider's office or laboratory facility) can detect pregnancy 8-11 days after conception.

Is it painful to have an IUS inserted?

An IUS insertion is usually well tolerated by most women. Some women may experience pain and dizziness after insertion, which usually settles after resting for a short time. Normal pain killers or local anesthesia may be applied to the uterine cervix prior to the insertion.

How often do condoms fail?

Compared to modern hormonal methods, condoms are less reliable and effective in protecting against pregnancy but they are the only method that will protect against STIs, including HIV/AIDS.

Can I reuse a condom?

No, reuse of any condom is not recommended – male or female. A new condom should be used every time you have intercourse.

How effective is the withdrawal method?

Withdrawal is less effective than most other contraceptive methods. As commonly used, it is only 78 percent effective, meaning that 22 of every 100 women whose partners use withdrawal will become pregnant over a year.

I have been taking the pill but did not get my period this month. Am I pregnant?

If you are regularly taking the pills, you are very unlikely to be pregnant. The pill is highly effective. If your period does not come, it does not necessarily mean that you are pregnant as long as you did take it as directed. It could be that the lining of your womb has not built up very much and is therefore not being expelled. If menstruation does not come for more than two months in a row talk to your doctor or healthcare provider before you start taking the new strip.

How long after having unprotected sex can the emergency pill be taken?

The emergency pill must be taken within 72 hours (three days) after unprotected sex. The sooner it is taken, the more effective it is. It is most effective if it is taken within the first 12 hours after unprotected sex.

Will douching help to prevent pregnancy after coitus interruptus?

No not all, however it is far better to bathe and make sure that anything with ejaculate on it does not get near the vagina within one to six hours, their known lifespan outside the body.

Should women not use hormonal contraceptives when they’re breastfeeding?

Hormonal methods are a definite option while you are breastfeeding, but not all of them are appropriate: products containing estrogens should not be used because this hormone can have an effect on milk production. Progestin on the other hand, is an option - especially those with "local" effects such as hormonal intrauterine systems (IUS). The volume and composition of breast milk are not affected. Three-monthly injections, progestin-only pills and hormonal implants are other contraceptive options for women who are breastfeeding. Ask your doctor or healthcare provider for further information.

How can stretch marks be prevented?

Unfortunately, striae (stretch marks) cannot be prevented. The degree to which a woman experiences stretch marks is determined genetically. Stretch marks usually occur when weight is lost or gained quickly. Using creams and gels rarely make a difference. Fortunately, stria fades with time and marks become silvery white, but they do not tan.

When will the uterus return to normal size?

The uterus returns to pre-pregnancy size after approximately 6 weeks. This is accomplished through a process called involution. During this process, the uterus has contractions that women may be able to feel, especially with breastfeeding.

Why do pregnant women feel tired?

Fatigue in early pregnancy is very normal. Many changes are occurring as the new pregnancy develops, and women experience this as fatigue and an increased need for sleep. Lower blood pressure level, lower blood sugar levels, hormonal changes due to the soporific effects of progesterone, metabolic changes, and the physiologic anemia of pregnancy all contribute to fatigue. Women should check with their health care provider to determine if an additional work up, prenatal vitamin changes, and/or supplemental iron would be beneficial.

You can't get pregnant while breastfeeding, can you?

There is still a very widespread misconception (that has already provided many a baby with a little brother or sister) that women can't get pregnant while breastfeeding. Breastfeeding does actually have an inhibitory effect on fertility/ovulation. But it is only possible with hindsight for a nursing mother to know for sure whether or not she has ovulated, i.e. when she has her first period.

And once solids are introduced (when you start to give your baby other foods in addition to breast milk), there is an increased likelihood of you starting to ovulate again, with a return to fertility. If you don't wish to take any risks, then you should also use contraception while breastfeeding. Your gynecologist will tell you which methods of contraception are appropriate for you.

Are condoms the only effective way of preventing sexually transmitted infections?

Yes. Condoms have been proven to provide protection against sexually transmitted infections (STIs). In fact, condoms are the only contraceptive method that also provides STI protection. Condoms provide different levels of risk reduction for different STIs because infections are spread differently—some are spread by contact with bodily fluids while others are spread by skin to skin contact.

In general, research shows that condoms are most effective in preventing those STIs that are spread by bodily fluids, such as chlamydia, gonorrhea, and HIV. Condoms also can reduce the risk of contracting diseases spread by skin-to-skin contact, such as herpes and human papillomavirus (HPV). However, condoms only can protect against these diseases if the sores are in areas covered by the condom.

Who is more at risk of becoming infected with an STI, men or women?

If exposed to STIs, women are more likely to become infected than men due to biological factors. Women have a greater area of exposure (the cervix and the vagina) than men, and small tears may occur in the vaginal tissue during sex, making an easy pathway for infection.

Can HIV be transmitted through hugging, shaking hands or mosquito bites?

HIV cannot be transmitted through casual contact. This includes closed mouth kissing, hugging, shaking hands, and sharing food, clothing, or toilet seats. The virus cannot survive long outside of the human body. Mosquitoes cannot transmit HIV, either.

Will having sex with a virgin cure someone with an STI, including HIV?

No. Instead, this practice only risks infecting the person who has not yet had sex.

Will washing the penis or vagina after sex lower the risk of becoming infected with an STI?

Genital hygiene is important and a good practice. There is no evidence, however, that washing the genitals prevents STI infection. In fact, vaginal douching increases a woman's risk of acquiring STIs, including HIV, and pelvic inflammatory disease.

Does pregnancy place women at increased risk of becoming infected with HIV?

Current evidence is conflicting as to whether pregnancy increases a woman's chances of infection if exposed to HIV. If she does become infected with HIV during pregnancy, however, the chances that HIV will be transmitted to her baby during pregnancy, delivery, and childbirth may be at their highest because she will have a high level of virus in her blood. Thus, it is important for pregnant women to protect themselves from HIV and other STIs through condom use. If a pregnant woman thinks that she may have HIV, she should seek HIV testing. Resources may be available to help her prevent transmitting HIV to her baby during pregnancy, delivery, and childbirth.

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