Medical App & Medical Advice with Hello Doctor

Nine months after the night before the morning after pill

The first week of September is one of the most popular weeks for unprotected sex in South Africa. We don’t know if it’s the smell of blossoms in the air, the first rays of sun or those floral skirts parading the streets, but this time of year, people everywhere are getting it on.

How do we know this? Because, come June, our hospitals will be filled to the brim with brand-spanking new babies. (It also means, if you’re a June baby, you were conceived in this very month.)

So, if you want to avoid being part of the statistics, here are three words of advice: use birth control! And if ‘contraception’ sounds like a passion-killer to you, you’ll need to weigh it up against sleepless nights, nappy-changes and preparing a small adult for their life.

Not ready for that? Then we have four (plus one back-up) ways to have adult fun, in an adult way:

1. Cover your lover

Ribbed, unribbed, strawberry-flavour, glow-in-the-dark, extra strength, extra thin and even warming condoms: the latex industry sure knows how to turn protection into a sport (or a circus). If there’s one thing you can’t say, it’s that condoms will make sex boring. If anything, it opens up whole new levels of experience.

You can even take turns wearing the ‘glove’. Yes, gents – there are also female condoms and diaphragms available. Just take note: it’s not as comfortable or effective as a male condom.

2. One-a-day

No, we’re not talking about apples here. Although an apple a day won’t keep the doctor away; a tablet a day will prevent babies – 99,9% of the time. Yes, that is not a typo. If you take the pill every day, you only have a 1 in 1000 chance of falling pregnant.

So what about your neighbour and her cousin and who fell pregnant while on the pill? Although the drug itself is almost 100% effective, omen aren’t nearly as effective at taking them every single day, which brings us to our next option:

3. Fit and forget

It’s one of the simplest, least painful procedures, and can last you up to 5 years. The IUD (or intrauterine device) is a small T-shaped device that the doctor inserts into your uterus. They are

  • effective at preventing pregnancy
  • have almost no side-effects (unlike the pill)
  • can be taken out once you’re ready to welcome another bundle of joy into your life.

There you have it: three fantastic reasons to pick up your phone right now, and book an appointment with your Gynae.

4. Closing the factory

Then, of course, there are the more permanent options: vasectomy for the men, or tubal ligation for the women. These operations have low-risk, quick recovery, and permanent results.
This is the best option if you’re at the stage of life where you can’t imagine another run of nappies, school-fees, teenage drama and study loans. When your family is at capacity, just go for the snip. Then you can rekindle those flames of passion from B.C. (Before Children) with zero worries.

EEK! The condom broke!

When all else fails, the morning after pill is an effective (but controversial) back-up plan, available at most pharmacies. Just remember to take it as soon as possible after unprotected sex: no later than 5 days.

Here are some classic situations where you may need it:

  • you’re reading this article the morning after, and did not use protection last night
  • you didn’t check the expiry date on your condom, and it broke
  • you forgot to take the pill yesterday and the day before (set reminders on your phone!)
  • you’ve been vomiting or had diarrhoea while on the pill

So, while spring is in the air, and love is all around, rubber-up, pop a pill or snip. Just don’t get caught with your pants down!

By Dr. Albert J. Viljoen

Stopped The Pill? Here’s why you’re not menstruating.

Maybe you’ve decided it’s time to have a baby. Or, you just want to go off contraception. When you go off the pill, you expect your menstrual cycle to get back to normal; but what happens when your cycle doesn’t start?

Post-pill amenorrhea

This is a fancy way of saying that many women experience a delay of menstruation after stopping the birth control pill. You could also experience spotting, or a much lighter flow during your period. It might carry on this way for up to six months. In most cases, the effect is temporary and your cycle may return on its own after a couple of months.

Why it happens

Birth control pills suppress your pituitary gland from making hormones involved in ovulation and menstruation. When you stop taking the pill, it may take some time for your body to return to normal production of these hormones.

It’s like your body has unlearnt how to produce the hormones, so it may take some time to get back into the normal cycle.

What can you do about it?

Technically, this isn’t a medical condition, and you can just wait for your body to get back to normal. If you don’t get your period within the first three months, take a pregnancy test or go see a doctor. Once you stop taking the pill, your ovaries take about two weeks before the process of ovulation starts again and normal menstrual cycle restarts after a few months.

Can I get pregnant after stopping the pill?

Research suggests that most of the time, birth control doesn’t necessarily have a negative impact on fertility. Many women go off the pill and conceive on the very first cycle. Your body will gradually begin to get back to its normal state. The good news is that you can get pregnant during your first cycle after stopping the pill.

When do I see the doctor?

The time-limit to get your period may vary; it could be between six to nine months. See your doctor if you’re anxious and the wait feels too long. He may advise an active treatment that can be started as soon as possible. He may prescribe Clomiphene Citrate. This is a medication that’s used to treat infertility in women who don’t ovulate. It works by stimulating your pituitary gland to produce FSH and LH. There are other medications available that your doctor may prescribe too, but the best is to let your body take its normal course.

References:

The basics of birth control

Today, there are more options than ever to prevent pregnancy – and stay sexually safe. With guidance from your doctors and the many options to choose from, you can go for a birth control of your choice that will fit your budget and lifestyle.

The job of birth control is to keep the sperm and egg apart during sexual intercourse. Here’s what you need to know about the most popular methods. Remember, contraceptives don’t protect you from sexually transmitted diseases and HIV/AIDS. So, it’s still a good idea to always use a condom as well.

Method How it works Good to know
Implant A small plastic rod is inserted under the skin of your upper arm. It releases a hormone called progesterone into your body. The hormone thickens the mucous of the neck of the womb to prevent sperm from entering. It prevents ovulation (stops eggs from leaving your ovaries) and thins the lining of the womb so it’s not able to support a fertilised egg.

 

·       It’s 99% effective within the first seven days of insertion.

·       You can have the implant for up to three years and it’s generally safe for most women to use.

·       Once it’s in, you don’t have to worry about a daily or monthly routine for your next contraceptive dose.

·       There could be some side-effects like bruising, occasional soreness, irregular bleeding, headaches, nausea, and acne.

 

The patch The thin, beige plastic patch releases hormones through the skin to prevent pregnancy. It can be placed on your buttocks, abdomen, and arm.

 

·       It’s about 92-99% effective.

·       It’s generally safe, convenient, discreet, and doesn’t disrupt sex. This method is also easier for women who have trouble swallowing pills.

·       The side-effects may include your period flow being lighter or irregular. With generally no risks to using this method, there’s a slight risk of developing blood clots. Your oestrogen levels are higher and this could lead to weight gain, bloating, water retention, and other health issues.

 

The pill The hormones in the pill stop eggs from developing, therefore there is no egg released from the ovary.

 

·       Taken daily at a specific time, it can give you 99% birth control.

·       The pill does more than prevent pregnancy, but has other health perks too. It helps and reduces acne, menstrual pain, iron deficiency, and bone thinning. It also lowers the risk of ectopic pregnancy (a pregnancy outside of the uterus, which can damage organs and cause life threatening blood loss).

·       You will have to take the pill every day at the same time.

·       It may change the level of your sexual desire too.

·       Weight gain may result because of fluid retention and not from the actual pill.

 

 

 

Before you choose your option, know that some digestive disorders make it difficult for your body to maintain an oral birth control (like pills). Certain antibiotics can also make your birth control ineffective, so talk to your doctor before using any new medications.

Other methods include:

  • Vaginal ring
  • Cervical cap
  • Condom
  • Diaphragm
  • Female condom
  • IUD
  • Abstinence
  • Spermicide
  • Vasectomy
  • Sterilisation

Check with your doctor to see what may be suitable for you.

References