Here are some topics that women in their 20's often ask about.
Making the Decision to Get Pregnant:
The decision to get pregnant shouldn't be made lightly. You need to factor in all of the mental, physical and emotional requirements you have and address these first. Ask yourself these questions:
- Are you ready for a baby?
- Do you have the insurance you need?
- Can you afford what your insurance won't cover?
- Can you fix the difference between the two?
- Do you know what maternity and paternity benefits you have?
- What will you need before the baby? (Space, Car, Baby Stuff, etc.)
When planning for a pregnancy it is always a good idea to have a visit with your physician. This consultation is known as a preconception health visit. The point of the visit is to get a picture of your health and to prepare your body for conception. This will help you ensure that you are physically ready for pregnancy and that your baby will be as healthy as possible.
During the visit you will answer a round of health questions. This will be used by your practitioner to help determine if you have any chronic diseases that require regulation before getting pregnant. This is also the perfect time to bring in a list of your medications so that you can get advice on if any medications need to be discontinued or switched before or during pregnancy. This is also a great time to ask about birth control. Many women who are taking birth control pills are unsure about when they need to stop taking the pill in order to conceive.
You will have a physical examination which is likely to include your annual pap smear and a breast exam. Your practitioner will go over what steps you need to take in order to prepare your body for pregnancy.
It is advisable to go for this appointment at least six months prior to wanting to get pregnant. This gives you time to work on any health issues you may have. Though some women choose to go just a menstrual cycle or two before getting pregnant. Your physician can also give you general advice on getting pregnant. This may include figuring out how to tell when you ovulation. Because pinpointing ovulation will help you get pregnant more quickly. They will also give you advice on nutrition, prenatal vitamins and when to seek prenatal care or advice on not getting pregnant as quickly as you would like.
Planning Pregnancy for Your Body: Your baby has the best chance of being healthy when you plan for pregnancy. This means you need to see your physician for a preconception health visit. Here you'll talk about managing any chronic conditions you have like asthma, diabetes, high blood pressure, etc. What to do with the current medications you take before, during and after pregnancy. You will also discuss how to take prenatal vitamins (including folic acid*) to help aid you in a healthy pregnancy. You should also discuss birth control options and changes you need to make before attempting to get pregnant.
The tricky part is that neural tube defects can occur in an embryo before a woman realizes she's pregnant. That's why it's important for all women of childbearing age (15 to 45) to include folate in their diets: If they get pregnant, it reduces the chance of the baby having a birth defect of the brain or spinal cord.
Folate's potential to reduce the risk of neural tube defects is so important that the Food and Drug Administration requires food manufacturers to fortify enriched grain products with folic acid. This will give women one way to get sufficient folate: by eating fortified breads and other grain products, such as enriched pasta, rice, waffles and cereal bars.
Other ways to do this are:
- Eat fruits, dark-green leafy vegetables, dried beans and peas, and other foods that are natural sources of folate.
- Eat folic acid-fortified enriched cereal grain products and breakfast cereals.
- Take a vitamin supplement containing folic acid.
Nutrition information on food and dietary supplement labels can help women determine whether they are getting enough folate, which is 400 micrograms (0.4 milligrams) a day before pregnancy and 800 micrograms a day during pregnancy.
How to Get Pregnant: It is important that you know the basics of conception. This will help increase your chances of pregnancy every month. The key is to find out when you ovulate. You can figure this out by a simple calendar method, ovulation prediction kits or monitors, and other devices to predict ovulation. You will want to have sex near ovulation, since the egg is only viable for about 24 hours. The good news is that sperm lives longer. Taking Charge of Your Fertility is an amazing book to help you with fertility charting and getting pregnant.
Once you start trying to get pregnant, you may be anxious for your period every month. What may surprise you is that it usually takes more than a month of well- timed sex to get pregnant. This does not mean that you are infertile. If you find that your period is delayed or that you are experiencing signs of pregnancy, consider taking a pregnancy test.
Also called: Sexually transmitted infections, STDs, Venereal disease.
Sexually transmitted diseases (STDs) are infections that you can get from having sex with someone who has the infection. The causes of STDs are bacteria, parasites and viruses. Most STDs affect both men and women, but in many cases the health problems they cause can be more severe for women. If a pregnant woman has an STD, it can cause serious health problems for the baby.
If you have an STD caused by bacteria or parasites, your health care provider can treat it with antibiotics or other medicines. If you have an STD caused by a virus, there is no cure. Sometimes medicines can keep the disease under control. Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading STDs.
Centers for Disease Control and Prevention
There are more than 20 types of STDs, including:
Chlamydia is a common sexually transmitted disease caused by bacteria. You get it by having sex or sexual contact with someone who is infected. Both men and women can get it. Chlamydia usually doesn't cause symptoms. If it does, you might notice a burning feeling when you urinate or abnormal discharge from your vagina or penis.
In both men and women, chlamydia can infect the urinary tract. In women, infection of the reproductive system can lead to pelvic inflammatory disease, which can cause infertility or serious problems with pregnancy. Babies born to infected mothers can get eye infections and pneumonia from chlamydia. In men, chlamydia can infect the epididymis, the tube that carries sperm. This can cause pain, fever and rarely, infertility.
You can cure chlamydia with antibiotics. If you are sexually active, you can decrease your risk of getting it by using condoms. Experts recommend that women 25 and younger get a chlamydia test every year.
National Institute of Allergy and Infectious Diseases
Also called: The clap
Gonorrhea is a curable sexually transmitted disease. It is most common in young adults. The bacteria that cause gonorrhea can infect the genital tract, mouth or anus.
Gonorrhea does not always cause symptoms, especially in women. In men, gonorrhea can cause pain when urinating and discharge from the penis. If untreated, it can cause epididymitis, which affects the testicles and can lead to infertility. In women, gonorrhea can cause bleeding between periods, pain when urinating and increased discharge from the vagina. If untreated, it can lead to pelvic inflammatory disease, which causes problems with pregnancy and infertility. Gonorrhea can pass from mother to baby during pregnancy.
You can cure gonorrhea with antibiotics prescribed by your health care provider. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading gonorrhea.
Centers for Disease Control and Prevention Herpes Simplex
Also called: HSV
Herpes is an infection that is caused by a herpes simplex virus (HSV). Oral herpes causes cold sores around the mouth or face. Genital herpes affects the genitals, buttocks or anal area. Genital herpes is a sexually transmitted disease (STD). You can get it from having sex, even oral sex. The virus can spread even when sores are not present. Mothers can also infect their babies during childbirth.
Some people have no symptoms. Others get sores near the area where the virus has entered the body. They turn into blisters, become itchy and painful, and then heal. The virus can be dangerous in newborn babies or in people with weak immune systems.
Most people have outbreaks several times a year. Over time, you get them less often. Medicines to help your body fight the virus can help lessen symptoms and decrease outbreaks. Correct usage of latex condoms can reduce, but not eliminate, the risk of catching or spreading herpes.
Centers for Disease Control and Prevention
Also called: Acquired immunodeficiency syndrome, HIV, Human immunodeficiency virus
AIDS stands for acquired immunodeficiency syndrome. It is the most advanced stages of infection with the human immunodeficiency virus (HIV). HIV is a virus that kills or damages cells of the body's immune system.
HIV most often spreads through unprotected sex with an infected person. AIDS may also spread by sharing drug needles or through contact with the blood of an infected person. Women can give it to their babies during pregnancy or childbirth.
The first signs of HIV infection may be swollen glands and flu-like symptoms. These may come and go a month or two after infection. Severe symptoms may not appear until months or years later.
A blood test can tell if you have HIV infection. Your health care provider can perform the test, or call the National AIDS hotline for a referral at (800) 342-AIDS (1-800-342-2437). There is no cure, but there are many medicines to fight both HIV infection and the infections and cancers that come with it. People can live with the disease for many years.
National Institute of Allergy and Infectious Diseases
Also called: Human Papillomavirus
Human papillomaviruses (HPV) are common viruses that can cause warts. There are more than 100 types of HPV. Most are harmless, but about 30 types put you at risk for cancer. These types affect the genitals and you get them through sexual contact with an infected partner. They are classified as either low-risk or high-risk. Low-risk HPV can cause genital warts. High-risk HPV can lead to cancers of the cervix, vulva, vagina, and anus in women. In men, it can lead to cancers of the anus and penis.
Although some people develop genital warts from HPV infection, others have no symptoms. Your health care provider can treat or remove the warts. In women, Pap smears can detect changes in the cervix that might lead to cancer.
Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading HPV. A vaccine can protect against several types of HPV, including some that can cause cancer.
National Institute of Allergy and Infectious Diseases
Syphilis is a sexually transmitted disease caused by bacteria. It infects the genital area, lips, mouth, or anus of both men and women. You usually get syphilis from sexual contact with someone who has it. It can also pass from mother to baby during pregnancy.
The early stage of syphilis usually causes a single, small, painless sore. Sometimes it causes swelling in nearby lymph nodes. If you do not treat it, syphilis usually causes a non-itchy skin rash, often on your hands and feet. Many people do not notice symptoms for years. Symptoms can go away and come back.
The sores caused by syphilis make it easier to get or give someone HIV during sex. If you are pregnant, syphilis can cause birth defects, or you could lose your baby. In rare cases, syphilis causes serious health problems and even death.
Syphilis is easy to cure with antibiotics if you catch it early. Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading syphilis.
National Institute of Allergy and Infectious Diseases
Trichomoniasis is a sexually transmitted disease caused by a parasite. It affects both women and men, but symptoms are more common in women. Symptoms in women include a green or yellow discharge from the vagina, itching in or near the vagina and discomfort with urination. Most men with trichomoniasis don't have any symptoms, but it can cause irritation inside the penis.
You can cure trichomoniasis with antibiotics. In men, the infection usually goes away on its own without causing symptoms. But an infected man can continue to infect or reinfect a woman until he gets treated. So it's important that both partners get treated at the same time. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading trichomoniasis.
Centers for Disease Control and Prevention
You're getting married! Discuss these premarital questions about money, sex, career & kids. Be willing to accept the answers because they may change your wedding plans.
These premarital questions will more likely ensure a healthy relationship - because unfortunately great marriages don't just evolve on their own! Before the wedding day or even before you start planning the wedding, consider these premarital questions. These categories cover money, sex, the household, children, and career.
These premarital questions are crucial because getting married may be the single most important thing you ever do.
10 Premarital Questions:
Premarital Questions About Money
1. Am I a spender or saver – and what's my partner? Are we comfortable spending money on the same things (such as organic food), or do we argue about money on dates or vacations (such as who should pick up the tab)? Another premarital question about money: Will we have joint or separate accounts, and who will pay the bills?
2. Are we in debt? What are our plans for getting out of debt, and do we have retirement goals? Have we taken a money management course for couples? A money-making premarital question: Who's responsible for the investments?
Premarital Questions About Sex
3. Have we discussed our sexual health? Do either of you have a sexually transmitted disease, and are you taking measures to prevent it from spreading? Can you comfortably discuss your intimate body parts and functions? A body image premarital question: Does your weight or appearance affect your sexuality – and can you be honest about that?
4. What do you know about our sexual preferences? Have you discussed premarital questions about the preferred time of day, number of times per week (or day), place, lights on or off, length of sexual contact, foreplay, or how adventurous you want to be?
5. Who cleans the bathroom, does the laundry, vacuums, and maintains the lawn/garden? Who cooks the meals and does the dishes? A good premarital question that's not often discussed: Who buys the groceries and maintains the car? What will your division of labor look like, especially if you have kids?
Premarital Questions About the Household
6. What are our pet peeves? Does it bother you if the toilet paper is on "upside down" or are you usually completely out altogether? Do you leave the cap off your toothbrush, the toilet seat up, or the fridge door open? A practical premarital question: Can you handle another person – even one you love – in "your space"?
Premarital Questions About Children
7. Have we, individually and as a couple, decided whether we want children? If so, have we considered how kids will affect our careers, lifestyle, recreation, privacy, social interests, money, and plans for the future? Figure this out before the wedding day.
8. What about infertility, birth defects, miscarriages, unplanned pregnancies, or other options such as fostering or adopting? Premarital questions need to include honest discussions about children.
Premarital Questions About Careers
9. Are we both professionally established? Should we both work full-time? Have we discussed whether one of us wants additional training, education, or experience? A typical premarital question: Can we afford changes in income, and does it mesh with our life goals as a married couple?
10. How do we deal with job stress? Are we grumpy or emotionally unavailable because we bring our work home – or work from home? Is our health affected by job stress? A practical premarital question is: Do we carry pagers or cell phones; if we have shift work does that impact our personal lives?
Choosing whether to breastfeed or formula feed your baby is one of the first decisions expectant parents will make. Although there's no right or wrong choice, the American Academy of Pediatrics (AAP) joins other organizations such as the American Medical Association (AMA), the American Dietetic Association (ADA), and the World Health Organization (WHO) in recommending breastfeeding as the best for babies. Specifically, the AAP says babies should be breastfed exclusively for the first 6 months and that breastfeeding should continue until 12 months (and beyond) if both the mother and baby are willing.
But breastfeeding (or nursing) may not be possible or preferable for all women. The decision to breastfeed or formula feed your baby should be based on your comfort level with breastfeeding as well as your lifestyle.
Breast milk is the ideal form of nutrition for newborns, but for mothers who are unable to breastfeed or who decide not to, infant formula is a good alternative. If you feed your baby with a commercially prepared formula, be assured that your baby's nutritional needs will be met. And you'll still bond with your baby just fine. After all, whether with breast milk or formula, feeding is an important time of connection between mother and baby.
The decision to breastfeed or formula feed your baby is a very personal one. But here are some points you may want to consider as you decide which is best for you and your new addition.
Breastfeeding: The Advantages
Nursing can be a wonderful experience for both mother and baby. It provides ideal nourishment and a special bonding experience that many nursing mothers cherish. Below are some of the many benefits of breastfeeding.
Infection-fighting - Antibodies passed from a nursing mother to her baby can help lower the occurrence of many conditions, including:
. ear infections
. respiratory infections
Other factors help to protect a breastfed baby from infection by contributing to the infant's immune system by increasing the barriers to infection and decreasing the growth of organisms like bacteria and viruses.
Breastfeeding is particularly beneficial for premature babies and may also protect children against:
. sudden infant death syndrome (SIDS)
As a group, formula-fed infants have more infections and more hospitalizations than do breastfed babies.
Nutrition and ease of digestion - Often called the "perfect food" for a human baby's digestive system, breast milk's components - lactose, protein (whey and casein), and fat - are easily digested by a newborn's immature system.
As a group, formula-fed infants have more difficulty with digestion than do breastfed infants. Breast milk tends to be more easily digested so that breastfed babies have fewer incidences of diarrhea or constipation.
Breast milk also naturally contains all the vitamins and minerals that a newborn requires. The Food and Drug Administration (FDA) regulates formula companies to ensure that they provide all the known necessary nutrients in their formulas. Commercial formulas do a pretty good job of trying to duplicate the ingredients in breast milk - and are coming closer - but haven't matched their exact combination and composition. Why? Because some of breast milk's more complex substances are too difficult to manufacture and some have not yet been identified.
Free - Breast milk doesn't cost a cent. And because of the immunities and antibodies passed onto them through their mothers' breast milk, breastfed infants are sick less often than infants who receive formula. For example, researchers have determined that infants who are exclusively breastfed for 4 or more months have 40% fewer episodes of ear infections. That means they make fewer trips to the doctor's office, which equates to fewer co-pays and less money doled out for prescriptions and over-the-counter medications.
Likewise, women who breastfeed are less likely to have to take time off from work to care for their sick babies. In a cost study published in the April 1999 issue of the journal Pediatrics, researchers determined that infants who were never breastfed would incur additional medical costs of $331 to $475 per year.
Different tastes - A nursing mother will need 500 extra calories per day to produce breast milk, which means that she should eat a wide variety of well-balanced foods. This introduces breastfed babies to different tastes through their mothers' breast milk, which has different flavors depending on what their mothers have eaten.
Convenience - With no bottles to mix and sterilize and no last-minute runs to the store for more formula, breast milk is always fresh and available. And because breast milk is always the right temperature, there's no need to warm up bottles in the middle of the night. It's also easy for breastfeeding mothers to be active - and go out and about - with their babies and know that they'll have food available for whenever their little one is hungry.
Obesity prevention - Recent studies indicate that breastfeeding might help prevent childhood and adult obesity. According to the National Women's Health Information Center (part of the U.S. Department of Health and Human Services), babies who are breastfed tend to gain less unnecessary weight, which may help them be less overweight later.
Smarter babies - Recent studies suggest that children who were exclusively breastfed for 6 months have IQs 5 to 10 points higher than children who were formula fed.
"Skin-to-skin" contact - Many nursing mothers really enjoy the experience of bonding so closely with their babies. And the skin-to-skin contact can enhance the emotional connection between mother and infant.
Beneficial for mom, too - The ability to nourish a baby totally can also help a new mother feel confident in her ability to care for her baby. Breastfeeding also burns calories and helps shrink the uterus, so nursing moms may be able to return to their pre-pregnancy shape and weight quicker. In addition, studies show that breastfeeding helps lower the risk of pre-menopausal breast cancer and also may help decrease the risk of uterine and ovarian cancer.
Breastfeeding: The Challenges
Although it is the best nutritional source for babies, breastfeeding does come with some concerns that many new mothers share. Whereas it's easy from the get-go for some, it can be challenging. Sometimes, both mother and baby need plenty of patience and persistence to get used to the routine of breastfeeding. But all the effort is often worth it in the long run - for both the mother and her baby.
Common concerns of new moms, especially during the first few weeks and months, may include:
Personal comfort - Initially, as with any new skill, many moms feel uncomfortable with breastfeeding. But with adequate education, support, and practice, most moms overcome this. The bottom line is that breastfeeding shouldn't hurt.
Latch-on pain is normal for the first week to 10 days, and should last less than a minute with each feeding. But if breastfeeding hurts throughout feedings, or if the nipples and/or breasts are sore, it's a good idea for breastfeeding mothers to seek the help of a lactation consultant, their doctor, and/or their child's doctor. Many times, it's just a matter of using the proper technique.
Time and frequency of feedings - There's no question that breastfeeding does require a substantial time commitment from mothers. Then again, many things in parenting do. Some women may be concerned that nursing will make it hard for them to work, run errands, or travel because of a breastfeeding schedule or a need to pump breast milk during the day.
And breastfed babies do need to eat more often than babies who are fed formula, because breast milk digests faster than formula. This means Mom may find herself in demand every 2 or 3 hours (maybe more, maybe less) in the first few weeks.
This can be tiring, but once breastfeeding has been established (usually in about a month), other family members may be able to help out by giving the baby pumped breast milk if Mom needs a break or has to get back to work outside the home. And it's not long before babies feed less frequently and sleep through the night (usually around 3 months). Also, with a little organization and time management, it becomes easier to work out a schedule to breastfeed and/or pump.
Limiting caffeine - Caffeine intake should be kept to no more than 300 milligrams (about one to three cups of regular coffee) per day for breastfeeding women because it may cause problems such as restlessness and irritability in some babies. But many women are used to drinking less caffeine anyway because they kept their caffeine consumption to a minimum during pregnancy. Women who enjoy caffeine, however, can still have a little by combining caffeinated and non-caffeinated drinks, and some might find they're satisfied just by trying similar-tasting non-caffeinated beverages.
Maternal medical conditions, medicines, and breast surgery - Medical conditions such as HIV or AIDS or those that involve chemotherapy or treatment with certain medications may make breastfeeding inadvisable. In these cases, a woman should check with her doctor or a lactation consultant if she's unsure if she should breastfeed with a specific condition or while taking medications.
But most moms are able to breastfeed even while on medications. Mothers who've had breast surgery, such as a reduction, may have difficulty with supply if their milk ducts have been severed. In this situation, it's a good idea for a woman to talk to her doctor about her concerns and work with a lactation specialist.
Formula Feeding: The Advantages
Breastfeeding is considered the best nutritional option for babies by the major medical organizations, but not every mother chooses - or is able - to breastfeed. Commercially prepared infant formulas are a nutritious alternative to breast milk and even contain iron.
Manufactured under sterile conditions, commercial formulas attempt to duplicate mother's milk using a complex combination of proteins, sugars, fats, and vitamins that would be virtually impossible to create at home. So, if you don't breastfeed your baby, it's important that you use only a commercially prepared formula and that you do not try to create your own.
In addition to medical concerns that may prevent breastfeeding, here are a few other reasons women may choose to formula feed:
Convenience - Either parent (or another caregiver) can feed the baby a bottle at any time (although this is also true for women who pump their breast milk). This allows the mother to share the feeding duties and helps her partner to feel more involved in the crucial feeding process and the bonding that often comes with it.
Flexibility - Once the bottles are made, a formula-feeding mother can leave her baby with a partner or caregiver and know that her little one's feedings are taken care of. There's no need to pump or to schedule work or other obligations and activities around the baby's feeding schedule. And formula-feeding moms don't need to find a private place to nurse in public. However, if Mom is out and about with baby, she will need to bring supplies for making bottles.
Time and frequency of feedings - Because formula digests slower than breast milk, formula-fed babies usually need to eat less often than do breastfed babies.
Diet - Women who opt to formula feed don't have to worry about the things they eat or drink affecting their babies.
Formula Feeding: The Challenges
As with breastfeeding, there are some challenges to consider when deciding whether to formula feed.
Organization and preparation - Enough formula must be on hand at all times and bottles must be made. The powdered and condensed formulas must be prepared with sterile water (which needs to be boiled until the baby is at least 6 months old) or bottled sterilized baby water. Ready-to-feed formulas that can be poured directly into a bottle without any mixing or water tend to be expensive.
Bottles and nipples need to be sterilized before the first use and then washed before every use after that (this is also true for breastfeeding women who give their babies bottles of pumped breast milk). Bottles and nipples can transmit bacteria if they aren't cleaned properly, as can formula if it isn't stored in sterile containers.
Bottles left out of the refrigerator longer than 1 hour and any formula that a baby doesn't finish must be thrown out. And prepared bottles of formula should be stored in the refrigerator for no longer than 24 to 48 hours (check the formula's label for complete information).
Bottles also may need to be warmed up before feeding the baby, although some babies actually prefer cold bottles to warm. Some parents pop bottles in the microwave for a few seconds; however, the microwave should never be used to warm a baby's bottle because it can create dangerous "hot spots."
Instead, run refrigerated bottles under warm water for a few minutes if the baby prefers a warm bottle to a cold one. Or the baby's bottles can be put in a pan of hot water (away from the heat of the stove) with the temperature tested by squirting a drop or two of formula on the inside of the wrist.
Lack of antibodies - None of the important antibodies found in breast milk is found in manufactured formula, which means that formula doesn't provide the baby with the added protection against infection and illness that breast milk does.
Expense - Formula can be costly. Powdered formula is the least expensive, followed by concentrated, with ready-to-feed being the most expensive. And specialty formulas (i.e., soy and hypoallergenic) cost more - sometimes far more - than the basic formulas. During the first year of life, the cost of basic formula can run about $1,500.
Possibility of producing gas and constipation - Formula-fed babies may have more gas and firmer bowel movements than breastfed babies.
Can't match the complexity of breast milk - Manufactured formulas have yet to duplicate the complexity of breast milk, which changes as the baby's needs change.
A Very Personal Decision - Whatever nutritional option you choose, be sure to talk to your child's doctor about the choices available to help you make the decision that's best for both you and your baby.
There are many methods of birth control. Learn about the different kinds of birth control to help you choose the best one for you. When making your choice, also consider that only a condom will help protect you from sexually transmitted diseases (STDs). To protect yourself and your partner against STDs, use a condom (along with your chosen birth control method) every time you have sex.
Hormonal methods are very reliable means of birth control. Hormonal methods use two basic formulas:
Combination hormonal methods contain both estrogen and progestin (synthetic progesterone). Combination methods include pills ("the Pill"), skin patches, and rings.
Progestin-only hormonal methods include pills, also called "mini-pills"; injections (Depo-Provera); and implants (Implanon). If you cannot take estrogen, a progestin-only method may be an option for you. See information about the progestin-only Mirena intrauterine device (IUD) below under IUDs.
Combination and progestin-only methods are prescribed for women for different reasons. Compare the recommendations for and against combination and progestin-only hormonal birth control pills, patches, implants, and rings. Each type of method has its pros and cons.
Combination pills may reduce acne, pain during ovulation, and premenstrual symptoms. Both types of pill reduce heavy bleeding and cramping. Unlike the combination pill, the progestin-only pill can be taken by almost all women, including those who are breast-feeding, although it must be taken at the same time each day to be effective. (Combination pills are also taken daily but without as much attention to the time of day.) When you first start taking either type of birth control pill, it is necessary to use a backup birth control method for the first week.
Patches or vaginal rings are similar to combination pills, but they don't require taking a daily pill. The patch is changed weekly, and the ring is changed monthly (with 1 week off after 3 weeks of use).
Some birth control pills reduce severe mood and physical symptoms that some women get before they start their monthly periods. These symptoms are called premenstrual dysphoric disorder (PMDD). There are birth control pills that are helpful for women who have migraines with their periods. There are also birth control pills for women who want fewer periods or who want to stop having periods.
The progestin-only (Depo-Provera) shot does not require taking a daily pill. Instead, you see your health professional once every 3 months for the injection.
The progestin-only hormone implant (Implanon) releases hormones that prevent pregnancy for about 3 years. It must be inserted and removed by a trained health professional. The actual implant is about the size of a matchstick and is inserted under the skin on the inside of the upper arm.
Intrauterine device (IUD)
An intrauterine device (IUD) is a small device that is placed in the uterus to prevent pregnancy. IUDs are wrapped with copper (Copper T 380-A) or contain a hormone (the Mirena IUD releases a progestin called levonorgestrel). Once an IUD is in place, it can provide birth control for 5 to 10 years, depending on the type. Unlike IUDs that were used in the 1970s, present-day IUDs are small, safe, and highly effective.
If a sexually transmitted disease is present at the time the IUD is inserted, the infection can be carried into the uterus. This can lead to pelvic inflammatory disease (PID), which can lead to infertility.
The progestin IUD (Mirena) typically reduces menstrual flow and cramping over time. On the other hand, the copper IUD can cause longer and heavier periods. However, the progestin IUD can have other side effects, including spotting, mood swings, and breast tenderness. These side effects occur less frequently than with other progestin-only methods.
Barrier methods (including the diaphragm; cervical cap; Lea's Shield; male condom; female condom; and spermicidal foam, sponge, gel, suppository, or film) prevent sperm from entering the uterus and reaching the egg. Typically, barrier methods are not highly effective, but they generally have fewer side effects than hormonal methods or IUDs. Spermicides and condoms should be used together or along with another method to increase their effectiveness. Barrier methods can interrupt lovemaking because they must be used every time you have sex.
Condoms (male or female) should always be used if you are at risk of getting or spreading a sexually transmitted disease, such as genital herpes, chlamydia, or HIV.
Fertility awareness requires that a couple chart the time during a woman's menstrual ycle when she is most likely to become pregnant and avoid intercourse or use a barrier method during that time. Fertility awareness is not a good choice if you need a highly effective form of birth control.
Breast-feeding may work as a form of birth control in the first 6 months after giving birth if you follow specific guidelines. For this method to work, you must breast-feed your baby every time. You can't use formula or other supplements. This is called the lactational amenorrhea method (LAM). Although LAM has been shown to be 98.5% effective when these conditions are met, many doctors recommend that you use another birth control method.
Permanent birth control (sterilization)
Sterilization is a surgical procedure done for men or women who decide that they do not want to have any (or more) children. Sterilization is one of the most effective forms of birth control. Sterilization is intended to be permanent, and although you can try to reverse it with another surgery, reversal is not always successful.
Tubal ligation or implants: Tubal ligation is a surgical procedure where the fallopian tubes, which carry the eggs from the ovaries to the uterus, are tied, cut, or blocked. A new nonsurgical sterilization technique uses a small metal coil, or tubal implant, inserted up into each fallopian tube. Over time, scar tissue grows around each tubal implant, permanently blocking the tubes. Most women are able to return home within a couple of hours after either procedure. You must use another form of birth control for 3 months after receiving tubal implants. At 3 months, you will need to have an X-ray taken to make sure that your tubes are closed.
Vasectomy: In this minor surgery, the vas deferens, the tubes that carry sperm from the testicles to the seminal fluid (semen), are cut and blocked so that the semen no longer contains sperm. This does not interfere with a man's ability to have an erection or enjoy sex. Men must have a sperm count check after having a vasectomy before relying on this for birth control.
Female sterilization is more complicated, has higher risks of problems after surgery, and is more expensive than male sterilization.
Contraception following pregnancy
Birth control is an important consideration after you have had a child. Your ability to become pregnant again may return within 3 to 6 weeks after childbirth. Think about what type of birth control you will be using, and make a plan during your pregnancy. Start using birth control as soon as possible after childbirth. Most methods of birth control can be started soon after childbirth, although some may not be recommended if you are breast-feeding.
Fertility Problems - Treatment
Your Lakeside physician can answer any questions you have related to fertility and treatment(s).
Before you and your partner start treatment for infertility, talk about how far you want to go. For example, you may want to try medicine but do not want to have surgery. While you may rethink this end point during your treatment, it’s a good idea to have an idea where you want to draw the line. Many couples do not think about this in the beginning and become emotionally and financially drained from trying a series of treatments.
Treatment for fertility can also be quite expensive, and insurance often does not cover these expenses. If cost is a concern for you, find out how much medicines and procedures cost and if your insurance covers any costs. Talk with your partner about what you can afford.
Keep in mind that some infertility problems are more easily treated than others. Note: as a women ages, especially after 35, her chances of getting pregnant decrease and her risk of miscarriage markedly increases.
If you are 35 or older, your doctor may recommend that you skip some of the steps younger couples usually take because your chances of having a baby decrease with each passing year.
Also, understand that even if you are able to get pregnant, no treatment can guarantee a healthy baby. On the other hand, scientists in this field have made many advances that have helped millions of couples have babies.
Your doctor will first try to find why you have not been able to get pregnant. She will do tests to look for a cause. Sometimes doctors do not find a problem with either the man or the woman and don't know why a woman cannot get pregnant.
Treatment for female infertility
Problems with ovulating. If your doctor finds that you have a problem with ovulating, she may first recommend that you try the medicine cloiphene (Clomid, Serophene, Milophene). This medicine (which you take as a pill) stimulates your ovaries to release eggs, so it improves your chances of getting pregnant. It is often tried first because it is considered safe and effective.
Clomiphene has more side effects than gonadotropins but clomiphene costs less, has a lower risk of ovarian hyperstimulation syndrome, and is less likely to result in a pregnancy with more than one baby.
If you're not ovulating because of a condition called polycystic ovary syndrome (PCOS), your doctor might suggest you take a drug such as metformin in combination with clomiphene. For more information, see treatment of women with polycystic ovary syndrome (PCOS).
Unfortunately, clomiphene does not always work. Typically, hormone shots are the next medication tried. You and your partner can weigh the risks and benefits of proceeding to this next step. You start the first series of daily shots at the beginning of your menstrual cycle. You will probably have mild side effects, such as feeling sick to your stomach and bloating. Some women have more serious side effects due to multiple, large ovarian cysts (ovarian hyperstimulation syndrome). While clomiphene increases your chance of having twins or triplets (especially twins), women who take hormonal injections are even more likely to have twins, triplets, or more babies.