What’s the difference between vaginal ring and oral contraceptive pill?
Both have hormones (Estrogen and Progesterone) but the main difference is the route of administration, the pill is taken by mouth and should be taken daily while the ring is per vaginal introduction and you should change it only once a month. With the pill you can have gastric problems such as nausea or abdominal pain and hepatic problems such as interference with metabolism of the pill by alcohol or some antibiotics that can decrease its effects. The ring with its vaginal absorption means that such problems don’t exist and it is more difficult to forget it, because you only have to change it once a month not daily like the pill. The side effects of contraceptive hormones such as fluid retention, headaches, circulation problems, etc. are the same in both due to the fact that they have the same hormonal composition.
If I use hormonal contraception for a long time, will I have any problems to get pregnant?
Not at all. Hormonal contraception does not affect fertility, it only regulates your periods. It works by giving a rest period to the ovaries while you take the hormones by mouth (pill), skin (sticker) or vagina (ring). When you stop using them, the ovaries restart their activity as it was before.
What do I have to do if I have spotting while on the pill or if my period is late?
If you have been using contraceptive hormones for a while without any problems and suddenly one month you have spotting, not to worry because the contraceptive hormones can be affected by external factors such as stress, alcohol….They can affect the metabolism of the pill and cause spotting.
If this happens two or more following months, just contact us.
If this spotting happens the very first time that you take the pill, it isn’t unusual because with the first blister pack of pills, the body must adapt itself to the hormones. After the first month that should stop.
If taking the pill properly (not forgetting any tablet), your period don’t come, that is ok because it means the effect of the pill keeps the endometrial lining so thin that it does not bleed. You should keep taking the pill without worries.
What happen if I forgot to take the pill?
If you forget one tablet, you should take it as soon as you notice and the next one, take it when is due. If it’s been more than 12 hr and/or you are in the middle of the blister pack, you should use an alternative method of protection because the pill is not safe enough.
Who can benefit of the Human Papiloma virus (HPV) vaccine?
Any woman at any age can use it. This vaccine acts against the Papiloma Virus, more specifically against the subtypes 16 and 18; they both cause 70% of cervical cancers. HPV is a sexual transmitted virus so any woman who has intercourse can have it. The vaccine is 100% effective in non sexual active women (virgins) but any women with a PAP smear negative, basically do not have an active HPV and can use the vaccine.
In the annual checkup, should we be tested for high risk HPV or just do a PAP smear?
In the annual checkup, we should only do PAP smears. People with pathological smears are the ones to consider for testing of high risk HPV.
We only have treatment for the cervical pathology so we only can treat the effects of the virus in the cervical tissue. We don’t have treatment for the virus itself so to test for it, if there is not an abnormal smear, is of no use.
Basically, the important thing is to have an annual PAP smear and if it is normal, forget about HPV.
If they perform a Hysterectomy on me, do I get menopause or does it come earlier?
If you have a hysterectomy without the removal of the ovaries, you do not have the menopause but your periods stop because the uterus is the organ that bleeds every month following orders from the ovaries.
Menopause is the finalization of your periods for over a year due to the definitive end of the ovarian activity. While the ovaries work, even if you don´t have the uterus, you have a cycle so you are not in the menopause because it depens on the ovaries not in the uterus.
In case of hysterectomy, the diagnosis of menopause is for hormonal blood results plus the menopausal symptoms you present.
What’s the difference between Arthritis and Osteoporosis?
The general believe is that if you have pain in your bones, it’s because you have osteoporosis. That’s a big mistake. Osteoporosis is a decrease on the mineralization of the bones. This is due to a decrease of the introduction of calcium in the bones because of the disappearance of estrogen from the circulation that occurs at the time of menopause, when the ovaries stop working.
The consequence of a decreased mineralization is an increased risk of bone fractures but it never causes pain.
On the other side, arthritis is the erosion of the articulations due to the time passing by… It happens to everybody (with a major or minor intensity) from a certain age. The principal symptom is pain and it has nothing to do with bone density.
If I have Thrush, can I pass it to my partner?
Candidacies (Thrush) is not a sexual transmitted infection, any woman at any age can have it, even children. The fungus called Candida lives in the vagina as part of the flora and in normal conditions you will not pick it up in a vaginal swab, but if there is a change in the vaginal pH it goes towards increasing Candida and it can give you thrush.
Some situations will favor the appearance of thrush such as increased humidity in vagina (swimming pool, beach), stress, antibiotics, and so on.
If you have thrush and you have intercourse, you can pass it to your partner at that moment, so if a woman has it and is sexually active, we advice treatment for both, her and her partner, as a prevention.
If I have polycystic ovaries, can I become pregnant?
The polycystic ovary is an ovary that does not ovulate regularly so the periods are irregular but they keep coming. If you ovulate then you can become pregnant but with the polycystic ovary, sometimes it’s difficult to know the day of the ovulation because it varies from one month to the other, but if your periods come once a month, you should get pregnant.
How often should I have a Mammography?
Once a year from the age of 40.
The mammography is the elective screening technique for the diagnosis of breast cancer. This is the most frequent cancer in women. Breast cancer is related to age with less than 5% of cases occurring before the age of 40. It is advisable to have an annual mammography trying for an early detection if it occurs.
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