Gynecology FAQ

When do I begin my birth control pills?

Begin your new pills on the first Sunday after the first day of your menses (the first Sunday after the first sign of bleeding). Always use back up protection for one month.

How do the pills affect my cycle?

The pill may make your cycle longer, shorter, or occasionally you may not have a cycle at all.

What do I do if I have break through bleeding while on birth control pills?

If you begin to bleed when you are not supposed to be bleeding, continue your pills. Stopping the pills may make the bleeding worse. Look back at the package to make sure you have taken all of your pills through today.  If you have not missed any pills, call your doctor, but please do not panic. This can be a normal side effect.

What do I do if I missed a pill?

Double up if only one or two pills have been forgotten. If more than two pills have been missed, you should wait until you have another period, and then restart the pills. Remember you should use back up protection for the first month of taking your pills.

How much weight will I gain on the pill?

There are no studies documenting weight gain on the pill. Equal numbers of people gain and lose weight on the pill. You may experience fluid retention, but this should not account for greater than five pounds. The newer pills have fewer side effects.

What can I do about headaches and/or mood swings on the pill?

The pill can aggravate some migraine headaches, especially if you have a history of migraines. There are a few potential remedies so be sure to ask your doctor. Mood swings can be a side effect of the birth control pills, however sometimes the pills may help alleviate mood swings by keeping your hormones at a steady level. Each type of birth control pill will have its own effects, so you may need to try a few to see which one works best for you.

I have no sex drive when I am on the pill.

Decreased libido can be a normal side effect of the pill.

I have been on birth control pills for years, do I need to stop taking my pills?

No. The pills of today are much lower in the amount of hormones, therefore reducing side effects.

I would like to be on birth control, however, I am not very good at taking a pill daily. Are there any other options?

Yes. There are many methods of birth control, presenting with their own unique benefits and risks. Types include birth control pills, a birth control patch, the NuvaRing, Nexplanon, Depo Provera injection, Mirena IUD and Paragard IUD. Discuss with your healthcare provider about which method may be best for you.

At what age and how often do I need to have a pap smear?

A pap smear is a swab done of your cervix to test for cervical cancer and precancerous lesions of the cervix. Recent guidelines state that your first pap smear should be obtained starting at age 21. How often you will need to be screened afterwards depends on what your results show. You should, however, continue with yearly checkups whether a pap smear is needed or not to help with health maintenance and screening for other medical issues.

At what age and how often do I need to have a mammogram?

A mammogram is an x-ray exam of the breast used to detect changes in the breast tissue to look for signs of breast cancer. ACOG recommends screening every 1-2 years for women age 40 and older and yearly for women age 50 and older. Women with certain family histories of breast cancer may need screening sooner.

At what age and how often do I need to have bone density screening?

A bone density screen is an x-ray exam used to measure bone density for screening and diagnosis of osteopenia and osteoporosis. Screening should begin at age 65 for all women, but women with certain medical conditions and family history may need to begin screening earlier. If results are normal, screening is usually done every 2 years.

How can I help protect myself against sexually transmitted diseases (STDs) and when should I be tested?

Abstinence from sexual practices is the only sure method for prevention of STDs. If participating in sexual practices, it is recommended to use condoms, which will help protect against most STDs when used correctly. Routine screening is not warranted for all women but you may consider testing if you have a new or multiple partners, prior history of STDs, or history of or current use of injection drugs. Most STDs do not present with symptoms and if contracted can cause issues with health and fertility, so be sure to ask your doctor if STD screening may be beneficial.

How can I help decrease my risk for cervical cancer?

HPV (human papillomavirus) is a sexually transmitted virus that has been shown to cause genital warts and cervical cancer. There are many types of HPV that can be categorized into low and high risk. Gardasil is a vaccine that helps protect against the four most common types of HPV that cause genital warts and cervical cancer. It is given usually between the ages of 11 and 26. It is best to receive your 3 Gardasil injections prior to first sexual intercourse, however, it is still recommended even if you have already become sexually active. Other ways to help reduce the risk of cervical cancer include avoiding risky sexual practices such as having sex at an early age, having multiple sexual partners, or having partners that participate in risky sexual practices. Stopping smoking may decrease your risk of cervical cancer as well. It has been shown that women who smoke are about twice as likely to get cervical cancer compared to nonsmokers.

What is insulin resistance and could I have it?

Insulin Resistance or Metabolic Syndrome is a condition in which the body does not efficiently use insulin, so your pancreas has to make a lot more insulin to regulate blood glucose. Some people with insulin resistance produce so much insulin that their blood sugar levels dive way below normal. Despite cutting down on fat intake, eating fat-free, low fat, or light foods, weight continues to increase. (The Insulin Resistance Diet)

Are you experiencing any of the following symptoms?

  • Fatigue
  • Weight gain
  • Difficulty losing weight
  • Increase in waist size, especially greater than 32 inches
  • Sleep Disturbances
  • Symptoms of hypoglycemia including jitteriness, tiredness, mental dullness, headaches, intense cravings for sugary or starchy foods, irritability, afternoon fatigue (especially after a heavy meal)
  • Family history of diabetes
  • Personal history of gestational diabetes with pregnancy
  • History of having large babies > 9 pounds
  • Skin tags
  • Darkening skin to you elbows, knees or around neck
  • Irregular menstrual periods
  • History of Polycystic Ovarian Syndrome
  • 30# or more overweight or BMI of 30 or more
  • Borderline or high blood pressure, even during pregnancy
  • High triglyceride levels
  • High LDL(bad) cholesterol > 130
  • Low HDL (good) cholesterol < 35
  • Native American, Asian, African American, or Hispanic Ancestry

If you are experiencing any of these symptoms, you may have insulin resistance or metabolic syndrome. The best way to determine if you have insulin resistance is to have a Homa Panel, which is a glucose tolerance test. Please contact one of our physicians or nurse practitioners if you have any concerns or would like to be tested.